Subcutaneous anti-hla-dr monoclonal antibody for treatment of hematologic malignancies

ABSTRACT

The present invention concerns compositions and methods of use of anti-HLA-DR antibodies or fragments thereof. In preferred embodiments, the antibodies are subcutaneously administered to a human patient with a hematologic cancer or autoimmune disease. The subcutaneously administered anti-HLA-DR antibody is effective to treat hematologic cancer or autoimmune disease in patients that have relapsed from or are refractory to standard therapies for hematologic cancer or autoimmune disease, such as administration of anti-CD20 antibodies, such as rituximab.

RELATED APPLICATIONS

This application claims the benefit under 35 U.S.C. 119(e) of U.S.Provisional Application Ser. No. 62/208,128, filed Aug. 21, 2015, and62/262,692, filed Dec. 3, 2015. This application is acontinuation-in-part of U.S. patent application Ser. No. 14/876,200,filed Oct. 6, 2015, which was a continuation of U.S. patent applicationSer. No. 14/163,443 (now U.S. Pat. No. 9,180,205), filed Jan. 24, 2014,which was a divisional of U.S. patent application Ser. No. 14/132,549,filed Dec. 18, 2013, which was a divisional of U.S. patent applicationSer. No. 13/461,307 (now U.S. Pat. No. 8,658,773), filed May 1, 2012,which claimed the benefit under 35 U.S.C. 119(e) of U.S. ProvisionalAppl. No. 61/509,850, filed Jul. 20, 2011 and 61/481,489, filed May 2,2011. The text of each priority application is incorporated herein byreference in its entirety

SEQUENCE LISTING

The instant application contains a Sequence Listing which has beensubmitted in ASCII format via EFS-Web and is hereby incorporated byreference in its entirety. Said ASCII copy, created on Aug. 11, 2016, isnamed IMM364US1_SL.txt and is 32,092 bytes in size.

FIELD OF THE INVENTION

The present invention concerns improved methods of treating hematologiccancers by subcutaneous administration of an anti-HLA-DR antibody orantigen-binding fragment thereof. In preferred embodiments, theanti-HLA-DR antibody or fragment thereof is a humanized L243 (hL243)antibody, as disclosed in the Examples below. More preferably, the hL243antibody is an IgG4 antibody, with decreased ADCC and CDC. Mostpreferably, the hL243 antibody comprises a Ser241Pro point mutation inthe hinge region of the antibody or fragment thereof. In particularembodiments, the anti-HLA-DR antibody is prepared in a concentratedformulation that allows for subcutaneous administration of small volumesof solution. In an exemplary embodiment, a dosage of 200 mg of antibodyis administered once, twice, or three times a week for the first threeweeks of a 4-week cycle. Patients may receive two or more consecutivetreatment cycles, followed by maintenance therapy (e.g., one week oftreatment every four weeks times 4). Preferably, administration inducesno more than a Grade 3 or Grade 4 toxicity. More preferably,administration results in a decrease in tumor size for solid tumors, ora decrease in white blood cell count for non-solid tumors. Decreases intumor size preferably are in the range of a 40% to 90% reduction intumor volume. The antibody or fragment may be administered alone, as aconjugate of a therapeutic agent, or in combination with one or moredifferent therapeutic agents, as discussed in detail below. Inparticularly preferred embodiments, the therapeutic agent is a Brutonkinase inhibitor (such as ibrutinib) or a PI3K inhibitor (such asidelalisib). The combination of antibody and therapeutic agentpreferably exhibits synergistic effects in treating hematologic cancers.

BACKGROUND

Rituximab anti-CD20 IgG therapy is credited with revitalizing antibodytherapies with its ability to effectively treat follicular lymphomawithout the extensive side effects associated with more traditionalchemotherapy regimens. Since rituximab's approval by the FDA in 1997,the mortality rate from NHL has declined by 2.8% per year (Molina, 2008,Ann Rev Med 59:237-50), and the use of this agent has been expanded to avariety of diseases. While rituximab has been a remarkable success infollicular non-Hodgkin lymphoma (NHL), for which it was first approved,only half of the patients had an objective response, with at most 10%having a complete response (McLaughlin et al., 1998, J Clin Oncol16:2825-33). Rituximab was less effective in the more aggressive typesof NHL, such as diffuse large B cell lymphoma (DLBCL), but when it wascombined with combination chemotherapy, improved and durable objectiveresponses compared to the separate therapies were found, making R-CHOP astandard protocol for the treatment of DLBCL (e.g., Leonard et al.,2008, Semin Hematol 45:S11-16; Friedberg et al., 2002, Br J Haematol117:828-34). The success of rituximab stimulated the evaluation of anumber of other antibodies and antibody conjugates, and while a numberof these have shown promising activity, to-date only one otherunconjugated antibody therapy, alemtuzumab (anti-CD52) for chroniclymphocytic leukemia (CLL), has been approved for use in hematologicmalignancies (Robak, 2008, Curr Cancer Drug Targets 8:156-71).

The human leukocyte antigen-DR (HLA-DR) is one of three isotypes of themajor histocompatibilty complex (MHC) class II antigens. HLA-DR ishighly expressed on a variety of hematologic malignancies and has beenactively pursued for antibody-based lymphoma therapy (Brown et al.,2001, Clin Lymphoma 2:188-90; DeNardo et al., 2005, Clin Cancer Res11:7075s-9s; Stein et al., 2006, Blood 108:2736-44). The human HLA-DRantigen is expressed in non-Hodgkin lymphoma (NHL), chronic lymphocyticleukemia (CLL), and other B-cell malignancies at significantly higherlevels than typical B-cell markers, including CD20. Preliminary studiesindicate that anti-HLA-DR mAbs are markedly more potent than other nakedmAbs of current clinical interest in in vitro and in vivo experiments inlymphomas, leukemias, and multiple myeloma (Stein et al., unpublishedresults).

HLA-DR is also expressed on a subset of normal immune cells, including Bcells, monocytes/macrophages, Langerhans cells, dendritic cells, andactivated T cells (Dechant et al., 2003, Semin Oncol 30:465-75). Thus,it is perhaps not surprising that prior attempts to develop anti-HLA-DRantibodies have been hampered by toxicity, notably infusion-relatedtoxicities that are likely related to complement activation (Lin et al,2009, Leuk Lymphoma 50:1958-63; Shi et al., 2002, Leuk Lymphoma43:1303-12).

The L243 antibody (hereafter mL243) is a murine IgG2a anti-HLA-DRantibody. This antibody may be of potential use in the treatment ofdiseases such as autoimmune disease or cancer, particularly leukemias orlymphomas, by targeting the D region of HLA. mL243 demonstrates potentsuppression of in vitro immune function and is monomorphic for allHLA-DR proteins. However, problems exist with the administration ofmouse antibodies to human patients, such as the induction of a humananti-mouse antibody (HAMA) response. A need exists for more effectivecompositions and methods of use of anti-HLA-DR antibodies, with improvedefficacy and decreased toxicity.

SUMMARY

In certain embodiments, the present invention relates to methods oftreating hematologic cancer, autoimmune disease or immune dysfunctiondisease (e.g., GVHD, organ transplant rejection) by subcutaneousadministration of an ant-HLA-DR antibody. Preferably the antibody ischimeric, humanized or human. More preferably, the anti-HLA-DR antibodycompetes for binding to, or binds to the same epitope of HLA-DR as, amurine monoclonal antibody mL243 comprising the murine L243 heavy chainCDR sequences CDR1 (NYGMN (SEQ ID NO: 39)), CDR2 (WINTYTREPTYADDFKG (SEQID NO: 40)) and CDR3 (DITAVVPTGFDY (SEQ ID NO: 41)) and the light chainCDR sequences CDR1 (RASENIYSNLA (SEQ ID NO: 42)), CDR2 (AASNLAD (SEQ IDNO: 43)), and CDR3 (QHFWTTPWA (SEQ ID NO: 44)). The murine L243 antibodyof use for competitive binding studies is publicly available from theAmerican Type Culture Collection, Rockville, Md., (see Accession numberATCC HB55). Most preferably, the anti-HLA-DR antibody comprises the L243heavy chain CDR sequences CDR1 (NYGMN (SEQ ID NO: 39)), CDR2(WINTYTREPTYADDFKG (SEQ ID NO: 40)) and CDR3 (DITAVVPTGFDY (SEQ ID NO:41)) and the light chain CDR sequences CDR1 (RASENIYSNLA (SEQ ID NO:42)), CDR2 (AASNLAD (SEQ ID NO: 43)), and CDR3 (QHFWTTPWA (SEQ ID NO:44)).

In other preferred embodiments, in addition to the L243 CDR referencesand human framework (FR) and constant region sequences, a humanizedanti-HLA-DR antibody may further comprise one or more of frameworkresidues 27, 38, 46, 68 and 91 substituted from the mL243 heavy chainand/or one or more of framework residues 37, 39, 48 and 49 substitutedfrom the mL243 light chain. In a more preferred embodiment, the hL243antibody comprises the sequences of SEQ ID NO:36 and SEQ ID NO:38.

In alternative embodiments, the anti-HLA-DR antibody may be a nakedantibody or an immunoconjugate that is attached to at least onetherapeutic agent. Conjugates with multiple therapeutic agents of thesame or different type are also encompassed. Alternatively, theanti-HLA-DR antibody may be administered in combination with at leastone therapeutic agent administered before, simultaneously with or afterthe anti-HLA-DR antibody. Any therapeutic agent known in the art, asdiscussed in more detail below, may be utilized in combination with orattached to the anti-HLA-DR antibody, including but not limited toradionuclides, immunomodulators, anti-angiogenic agents, cytokines,chemokines, growth factors, hormones, drugs, prodrugs, enzymes,oligonucleotides, siRNAs, pro-apoptotic agents, photoactive therapeuticagents, cytotoxic agents, chemotherapeutic agents, toxins, Bruton kinaseinhibitors, PI3K inhibitors, and other antibodies or antigen bindingfragments thereof.

In certain methods of use, the subject antibody may bind to at least oneepitope of HLA-DR on HLA-DR⁺ cells, resulting in cell death. In oneparticular embodiment, cell death may result without use of eithercytotoxic addends or immunological effector mechanisms, for example byinduction of apoptosis. The anti-HLA-DR antibodies may be of use fortherapy of any disease state in which HLA-DR⁺ cells are involved,including but not limited to various forms of cancer or autoimmunedisease.

In certain embodiments, the subject antibodies may be used in apharmaceutical composition for therapeutic and/or diagnostic use. Apharmaceutical composition may contain further therapeutic agents asdescribed below, in addition to other standard components such asbuffers, detergents, salts, excipients, preservatives and other suchagents known in the art. In particularly preferred embodiments, thecomposition may be a high-concentration formulation, as disclosed forexample in U.S. Pat. Nos. 8,658,773 and 9,180,205, incorporated hereinby reference.

The pharmaceutical composition or fusion protein or multispecificantibody may further comprise one or more additional antibodies orfragments thereof which bind to an antigen selected from the groupconsisting of carbonic anhydrase IX, alpha-fetoprotein (AFP),α-actinin-4, A3, antigen specific for A33 antibody, ART-4, B7, Ba 733,BAGE, BrE3-antigen, CA125, CAMEL, CAP-1, CASP-8/m, CCL19, CCL21, CD1,CD1a, CD2, CD3, CD4, CD5, CD8, CD11A, CD14, CD15, CD16, CD18, CD19,CD20, CD21, CD22, CD23, CD25, CD29, CD30, CD32b, CD33, CD37, CD38, CD40,CD40L, CD44, CD45, CD46, CD52, CD54, CD55, CD59, CD64, CD66a-e, CD67,CD70, CD70L, CD74, CD79a, CD80, CD83, CD95, CD126, CD132, CD133, CD138,CD147, CD154, CDC27, CDK-4/m, CDKN2A, CTLA-4, CXCR4, CXCR7, CXCL12,HIF-1α, colon-specific antigen-p (CSAp), CEA (CEACAM5), CEACAM6, c-Met,DAM, EGFR, EGFRvIII, EGP-1 (TROP-2), EGP-2, ELF2-M, Ep-CAM, fibroblastgrowth factor (FGF), Flt-1, Flt-3, folate receptor, G250 antigen, GAGE,gp100, GRO-β, HLA-DR, HM1.24, human chorionic gonadotropin (HCG) and itssubunits, HER2/neu, HMGB-1, hypoxia inducible factor (HIF-1), HSP70-2M,HST-2, Ia, IGF-1R, IFN-γ, IFN-α, IFN-β, IFN-.lamda., IL-4R, IL-6R,IL-13R, IL-15R, IL-17R, IL-18R, IL-2, IL-6, IL-8, IL-12, IL-15, IL-17,IL-18, IL-23, IL-25, insulin-like growth factor-1 (IGF-1), KC4-antigen,KS-1-antigen, KS 1-4, Le-Y, LDR/FUT, macrophage migration inhibitoryfactor (MIF), MAGE, MAGE-3, MART-1, MART-2, NY-ESO-1, TRAG-3, mCRP,MCP-1, MIP-1A, MIP-1B, MIF, MUC1, MUC2, MUC3, MUC4, MUC5ac, MUC13,MUC16, MUM-1/2, MUM-3, NCA66, NCA95, NCA90, pancreatic cancer mucin,PD-1, PD-1 receptor, PD-L1, placental growth factor, p53, PLAGL2,prostatic acid phosphatase, PSA, PRAME, PSMA, P1GF, ILGF, ILGF-1R, IL-6,IL-25, RS5, RANTES, T101, SAGE, 5100, survivin, survivin-2B, TAC,TAG-72, tenascin, TRAIL receptors, TNF-α, Tn antigen,Thomson-Friedenreich antigens, tumor necrosis antigens, VEGFR, ED-Bfibronectin, WT-1, 17-1A-antigen, complement factors C3, C3a, C3b, C5a,C5, an angiogenesis marker, bcl-2, bcl-6, Kras, and an oncogene product(see, e.g., Sensi et al., Clin Cancer Res 2006, 12:5023-32; Parmiani etal., J Immunol 2007, 178:1975-79; Novellino et al. Cancer ImmunolImmunother 2005, 54:187-207). The additional antibody or fragmentthereof may administered before, with, or after any pharmaceuticalcomposition containing a humanized anti-HLA-DR antibody.

Exemplary additional antibodies that may be utilized in combination withan anti-HLA-DR include, but are not limited to, hR1 (anti-IGF-1R, U.S.patent application Ser. No. 13/688,812, filed Nov. 29, 2012) hPAM4(anti-mucin, U.S. Pat. No. 7,282,567), hA20 (anti-CD20, U.S. Pat. No.7,151,164), hA19 (anti-CD19, U.S. Pat. No. 7,109,304), hIMMU31(anti-AFP, U.S. Pat. No. 7,300,655), hLL1 (anti-CD74, U.S. Pat. No.7,312,318), hLL2 (anti-CD22, U.S. Pat. No. 5,789,554), hMu-9 (anti-CSAp,U.S. Pat. No. 7,387,772), hL243 (anti-HLA-DR, U.S. Pat. No. 7,612,180),hMN-14 (anti-CEA, U.S. Pat. No. 6,676,924), hMN-15 (anti-CEA, U.S. Pat.No. 7,541,440), hRS7 (anti-EGP-1, U.S. Pat. No. 7,238,785) and hMN-3(anti-CEA, U.S. Pat. No. 8,287,865) the Examples section of each citedpatent or application incorporated herein by reference. The skilledartisan will realize that this list is not limiting and that any knownantibody may be used, as discussed in more detail below.

Various embodiments may concern use of the subject anti-HLA-DRantibodies or fragments thereof to treat or diagnose a disease,including but not limited to B cell non-Hodgkin's lymphomas, B cellacute and chronic lymphoid leukemias, Burkitt lymphoma, Hodgkin'slymphoma, hairy cell leukemia, acute and chronic myeloid leukemias, Tcell lymphomas and leukemias, multiple myeloma, Waldenstrom'smacroglobulinemia, carcinomas, melanomas, sarcomas, gliomas, and skincancers. The carcinomas may be selected from the group consisting ofcarcinomas of the oral cavity, gastrointestinal tract, pulmonary tract,breast, ovary, prostate, uterus, urinary bladder, pancreas, liver, gallbladder, skin, and testes. In addition, the subject anti-HLA-DRantibodies or fragments may be used to treat an autoimmune disease, forexample acute idiopathic thrombocytopenic purpura, chronic idiopathicthrombocytopenic purpura, dermatomyositis, Sydenham's chorea, myastheniagravis, systemic lupus erythematosus, lupus nephritis, rheumatic fever,polyglandular syndromes, bullous pemphigoid, diabetes mellitus,Henoch-Schonlein purpura, post-streptococcal nephritis, erythemanodosum, Takayasu's arteritis, Addison's disease, rheumatoid arthritis,multiple sclerosis, sarcoidosis, ulcerative colitis, erythemamultiforme, IgA nephropathy, polyarteritis nodosa, ankylosingspondylitis, Goodpasture's syndrome, thromboangitis obliterans,Sjogren's syndrome, primary biliary cirrhosis, Hashimoto's thyroiditis,thyrotoxicosis, scleroderma, chronic active hepatitis,polymyositis/dermatomyositis, polychondritis, pemphigus vulgaris,Wegener's granulomatosis, membranous nephropathy, amyotrophic lateralsclerosis, tabes dorsalis, giant cell arteritis/polymyalgia, perniciousanemia, rapidly progressive glomerulonephritis, psoriasis, or fibrosingalveolitis. In certain embodiments, the subject antibodies may be usedto treat leukemia, such as chronic lymphocytic leukemia, acutelymphocytic leukemia, chronic myeloid leukemia or acute myeloidleukemia.

Preferably, the antibody or fragment thereof may be designed or selectedto comprise human constant region sequences that belong to specificallotypes, which may result in reduced immunogenicity when theimmunoconjugate is administered to a human subject. Preferred allotypesfor administration include a non-G1m1 allotype (nG1m1), such as G1m3,G1m3,1, G1m3,2 or G1m3,1,2. More preferably, the allotype is selectedfrom the group consisting of the nG1m1, G1m3, nG1 m1,2 and Km3allotypes.

BRIEF DESCRIPTION OF THE DRAWINGS

The following drawings form part of the present specification and areincluded to further demonstrate certain embodiments of the presentinvention. The embodiments may be better understood by reference to oneor more of these drawings in combination with the detailed descriptionof specific embodiments presented herein.

FIG. 1 (also SEQ ID NO:31 and SEQ ID NO:32) illustrates an exemplary DNAencoding an amino acid sequence V_(K) of the mouse L243 anti-HLA-DRantibody. The putative CDR regions are underlined. Nucleotide residuesare numbered sequentially. Kabat's Ig molecule numbering is used foramino acid residues. The numbering for the residues with a letter (ontop) is the number of preceding residues plus the letter, eg, the numberfor T following N52 is 52A; the numbers for N, N and L following 82 are82A, 82B and 82C, respectively.

FIG. 2 (also SEQ ID NO:33 and SEQ ID NO:34) illustrates an exemplary DNAencoding an amino acid sequence V_(H) of the mouse L243 anti-HLA-DRantibody. The putative CDR regions are underlined. Nucleotide residuesare numbered sequentially. Kabat's Ig molecule numbering is used foramino acid residues as described above.

FIG. 3 (also SEQ ID NO:35 and SEQ ID NO:36) illustrates exemplary DNAand amino acid sequences of a humanized L243 V_(K). The bold andunderlined sections of the amino acid sequences indicate the CDRs asdefined by the Kabat numbering scheme.

FIG. 4 (also SEQ ID NO:37 and SEQ ID NO:38) illustrates exemplary DNAand amino acid sequences of a humanized L243 V_(H). The bold andunderlined sections of the amino acid sequences indicate the CDRs asdefined by the Kabat numbering scheme.

FIG. 5 illustrates an exemplary antigen-binding specificity of hL243.Raji cells, preincubated with a saturating concentration of mL234 (forblocking cell surface antigen (“Ag”) sites) or without, were resuspendedin PBS containing 1% BSA and 10 μg/ml of purified hL243 and incubatedfor 1 h at 4° C. After washing, the cells were resuspended in PBScontaining 1% BSA and PE-labeled goat anti-human IgG, Fc fragmentspecific antibody. After further incubation at 4° C. for 30 min, thecells were counted in a Guava PCA. The left side of the Figure showsspecific binding of hL243 to Raji human lymphoma cells, which wasblocked by preincubation of the cells with mL243. The right side of theFigure shows a negative binding control, performed with anti-CEAantibody (hMN-14) in place of hL243 under identical conditions.

FIG. 6 illustrates exemplary Ag-binding affinities comparing hL243 γ4Pand mL243 in a competitive cell surface binding assay. A constant amount(100,000 cpm, ˜10 μCi/μg) of ¹²⁵I-labeled mL234 (on left) or hL243γ4P(on right) was mixed with varying concentrations (0.2-700 nM) ofunlabeled hL243γ4P (solid triangle) or mL2343 (solid box). The mixtureswere added to Raji cells and incubated at room temperature for 2 h. Thecells were washed to remove unbound antibodies and the radioactivityassociated with the cells was counted. hL243γ4P and mL234 were shown tocompete with each other for binding to cell surface Ag. In both caseshL243γ4P appeared to bind to Raji cells more strongly than mL243.

FIG. 7 illustrates exemplary Ag-binding affinities of hL243γ4P and mL243determinated by direct cell surface saturation binding and Scachard plotanalysis. Varying concentrations of ¹²⁵I-labeled mL234 (solid square) orhL243γ4P (open triangle) were incubated with 2×10⁵ Daudi human lymphomacells at 4° C. for 2 h, and unbound radioactivity was removed from cellsuspensions by washing. The cell-associated radioactivity was counted,specific binding of radiolabeled antibody to the cell surface antigencalculated, and Scatchard plot analysis was then applied to determinethe maximum number of binding sites per cell and the apparentantigen-binding affinity constant. The maximum binding of mL234 orhL243γ4P to Daudi cell surface was 6×10⁶ molecules/cell. Thedissociation constants determined for mL234 or hL243γ4P were 14 and 2.6nM, respectively.

FIG. 8 illustrates that hL243 is effective in killing target cells inthe presence of human serum complement. Daudi cells were incubated withhL243, hL243γ4P, hA20 (a positive control), and hMN-14 (a negativecontrol) in the presence of human serum complement. hL243γ4P was shownnot to produce any complement-induced cytotoxicity.

FIG. 9A illustrates LDH release by ADCC as observed for hL243, hL243γ4P,hA20 (positive control) and hMN-14 (negative control).

FIG. 9B illustrates % cell lysis by ADCC as observed for hL243,hL243γ4P, hA20 (positive control) and hMN-14 (negative control).

FIG. 10 illustrates exemplary in vitro proliferative assays on Daudi(top) and Raji (bottom) cell lines at the end of 2 days.

FIG. 11A illustrates exemplary in vitro proliferative assays on Daudicell lines at the end of 3 days.

FIG. 11B illustrates exemplary in vitro proliferative assays on Rajicell lines at the end of 3 days.

FIG. 12 illustrates exemplary median survival times for tumor-bearingSCID mice injected with hL243γ4P.

FIG. 13 illustrates comparative induction of apoptosis in dog lymphomacells (measured as % cells with a sub GO/G1 phase DNA content) caused byL243, hL243 (IgG4 isotype), hMN-14 (humanized MN-14 IgG), and Ag8(murine myeloma derived mAb). L243 and hL243 caused apoptosis whencrosslinked with goat anti-mouse (GAM) and goat-anti human (GAH)antibodies respectively.

FIG. 14A illustrates anti-proliferative effects of humanized antibodies(hLL1, hLL2, Rituximab, hA2, hMN-14 and hL243 IgG4 isotype), with andwithout goat anti-human IgG (GAH)) on Namalwa human B cell lymphoma cellline as determined by a ³H-thymidine uptake assay with singleantibodies.

FIG. 14B illustrates anti-proliferative effects of humanized antibodies(hLL1, hLL2, Rituximab, hA2, hMN-14 and hL243 IgG4 isotype), with andwithout goat anti-human IgG (GAH)) on Namalwa human B cell lymphoma cellline as determined by a ³H-thymidine uptake assay with mixtures ofantibodies.

FIG. 15A illustrates CDC assays in Raji cells when exposed to variousantibodies disclosed herein.

FIG. 15B illustrates CDC assays in Ramos cells when exposed to variousantibodies disclosed herein.

FIG. 15C illustrates CDC assays in Namalwa cells when exposed to variousantibodies disclosed herein.

FIG. 16 illustrates ADCC assays and calcein AM release when SU-DHL-6cells are exposed to various antibodies disclosed herein.

FIG. 17A illustrates anti-proliferative effects of hL243γ4P on severalcell lines disclosed in MTT studies.

FIG. 17B illustrates anti-proliferative effects of hL243γ4P on severalcell lines disclosed in ³H-thymidine uptake assays. hL243 refers to theγ4P form of the antibody.

FIG. 18A illustrates induction of apoptosis. Dead cells are representedby clear and apoptotic cells are represented by solid bars. The Figureshows measurement of Sub G DNA in SU-DHL-6 and Namalwa cells. Cells usedhad 97% viability prior to treatment.

FIG. 18B illustrates induction of apoptosis. Dead cells are representedby clear and apoptotic cells are represented by solid bars. The Figureshows Annexin V/7-ADD at 4 and 24 hours. Cells used had 97% viabilityprior to treatment.

FIG. 19 illustrates mitochondrial membrane potential using a JC-1 assayin several cell lines.

FIG. 20A illustrates cleaved caspase-3 time course studies in Daudicells.

FIG. 20B illustrates P-AKT time course studies in Daudi cells.

FIG. 21 illustrates therapy of Raji-bearing SCID mice with murine L243and L243 γ4P.

FIG. 22A. In vitro effects of murine L243 on canine lymphoma aspirates.L234 binding to the aspirates from 4 dogs. White bars, Ag8; gray bars,L243.

FIG. 22B. In vitro effects of murine L243 on canine lymphoma aspirates.Percent apoptotic cells as measured by flow cytometry of hypodiploid DNA(sub G0) following propidium iodine staining. Incubations were performedwithout second antibody or in the presence of goat anti-mouse IgG: whitebars, Ag8 without second antibody; striped bars, Ag8 with GAM; graybars, L243 without second antibody; black bars, L243 with GAM; *, P<0.05vs. Ag8.

FIG. 22C. In vitro effects of murine L243 on canine lymphoma aspirates.Viable cell count was performed on two of the specimens by flowcytometry analysis of the cell count within a viable gate defined in theforward scatter vs. side scatter dot plot: white bars, Ag8 withoutsecond antibody; striped bars, Ag8 with GAM; gray bars, L243 withoutsecond antibody; black bars, L243 with GAM; *, P<0.05 vs. Ag8.

FIG. 23A. In vitro effects of IMMU-114 on canine lymphoma aspirates.Percent apoptotic cells as measured by flow cytometry of hypodiploid DNA(sub G0) following propidium iodine staining. Incubations were performedwithout second antibody or in the presence of goat anti-mouse IgG (GAM)or goat anti-human IgG (GAH). Error bars, SD of three replicates. *,significant change (P<0.05) relative to no mAb control.

FIG. 23B. In vitro effects of IMMU-114 on canine lymphoma aspirates.Percent specific lysis in CDC assays on aspirate of dog #171205. Errorbars, SD of three replicates. *, significant change (P<0.05) relative tono mAb control.

FIG. 23C. In vitro effects of IMMU-114 on canine lymphoma aspirates.Percent specific lysis in ADCC assays on aspirate of dog #171205. Errorbars, SD of three replicates. *, significant change (P<0.05) relative tono mAb control.

FIG. 24. Peripheral blood lymphocyte count and lymphocyte subsetphenotyping indicated a decrease in both B- and T-cell lymphocytes. ▪,total lymphocyte count; , T-cell count, relative to baseline; ◯, B cellcount, relative to baseline.

FIG. 25. Clearance of L243 in a dog with lymphoma (upper) and ofIMMU-114 in two normal dogs (middle and lower). The L243 dosesadministered in the dog with lymphoma (upper) were 1.5 mg/kg fortreatment 1 and 3.0 mg/kg for the remaining 3 treatments. IMMU-114 doseswere 3.0 mg/kg for the initial dose in both normal dogs (middle andlower). The second dose of IMMU-114 administered to second normal dog(lower) was 1.3 mg/kg.

FIG. 26. Effect of different specificity antibodies on survival. 250 μgof the indicated antibodies was injected twice per week for 4 weeks,starting 1 day after injection of WSU-FSCCL tumor cells.

FIG. 27. Ex vivo effects of mAbs on whole blood. Heparinized whole bloodof healthy volunteers was incubated with mAbs then assayed by flowcytometry. Data are shown as % of untreated control. Error bars, SD of 3replicates. *, P<0.05 relative to no mAb control.

FIG. 28. Effect of ERK, JNK and ROS inhibitors on hL234g4P mediatedapoptosis in Raji cells.

FIG. 29. Tumor reduction in a patient with follicular lymphoma treatedwith anti-HLA-DR antibody.

DETAILED DESCRIPTION Definitions

Unless otherwise specified, “a” or “an” means “one or more”.

“Antibody-dependent cell mediated cytotoxicity” or “ADCC” is acell-mediated reaction in which nonspecific cytotoxic cells that expressFc receptors (natural killer cells, neutrophils, and macrophages)recognize bound antibody on target cells and subsequently cause lysis ofthe target cells. The primary cells for mediating ADCC are the naturalkiller cells (express the FcDRIII only) and monocytes (express FcDRI,FcDRII and FcDRIII).

“Complement-dependent cytotoxicity” or “CDC” refers to the lysing of atarget in the presence of complement. The complement activation pathwayis initiated by the binding of the first component of the complementsystem (C1q) to a molecule (eg, an antibody) complexed with a cognateantigen.

The “Fc receptor” or “FcR” is used to describe a receptor that binds tothe Fc region of an antibody. Both CDC and ADCC require the Fc portionof a MAb and the effect of ADCC can be augmented by increasing thebinding affinity for FcγR (IgG Fc receptors) on effector cells(Shinkawa, et al, J Biol Chem 278: 3466-3473, 23; Shields et al, J BiolChem 211: 26733-2674, 22; Shields et al, J Biol Chem 276: 6591-664, 22;Davies et al, Biotechnol Bioeng 74: 288-294,21; and Umana et al, NatureBiotechnol 176-18, 1999).

An “antibody” as used herein refers to a full-length (ie, naturallyoccurring or formed by normal immunoglobulin gene fragmentrecombinatorial processes) immunoglobulin molecule (eg, an IgG antibody)or an immunologically active (ie, specifically binding) portion of animmunoglobulin molecule, like an antibody fragment. An “antibody”includes monoclonal, polyclonal, bispecific, multispecific, murine,chimeric, humanized and human antibodies.

A “naked antibody” is an antibody or antigen binding fragment thereofthat is not attached to a therapeutic or diagnostic agent. The Fcportion of an intact naked antibody can provide effector functions, suchas complement fixation and ADCC (see, e.g., Markrides, Pharmacol Rev50:59-87, 1998). Other mechanisms by which naked antibodies induce celldeath may include apoptosis. (Vaswani and Hamilton, Ann Allergy AsthmaImmunol 81: 105-119, 1998.)

An “antibody fragment” is a portion of an intact antibody such asF(ab′)₂, F(ab)₂, Fab′, Fab, Fv, sFv, scFv and the like. Regardless ofstructure, an antibody fragment binds with the same antigen that isrecognized by the full-length antibody. For example, antibody fragmentsinclude isolated fragments consisting of the variable regions, such asthe “Fv” fragments consisting of the variable regions of the heavy andlight chains or recombinant single chain polypeptide molecules in whichlight and heavy variable regions are connected by a peptide linker(“scFv proteins”). “Single-chain antibodies”, often abbreviated as“scFv” consist of a polypeptide chain that comprises both a V_(H) and aV_(L) domain which interact to form an antigen-binding site. The V_(H)and V_(L) domains are usually linked by a peptide of 1 to 25 amino acidresidues. Antibody fragments also include diabodies, triabodies andsingle domain antibodies (dAb).

Humanized L243 Antibodies

In preferred embodiments, the subject anti-HLA-DR antibody may be ahumanized L243 antibody. Such antibodies bind to the same epitope onHLA-DR as the parental murine L243 antibody, but have reducedimmunogenicity. mL243 is a monoclonal antibody previously described byLampson & Levy (J Immunol, 1980, 125:293). The amino acid sequences ofthe light and heavy chain variable regions of the mL243 antibody areshown in FIG. 1 and FIG. 2. mL243 has been deposited at the AmericanType Culture Collection, Rockville, Md., under Accession number ATCCHB55.

The humanized L243 antibodies may comprise the L243 heavy chain CDRsequences CDR1 (NYGMN (SEQ ID NO: 39)), CDR2 (WINTYTREPTYADDFKG (SEQ IDNO: 40)) and CDR3 (DITAVVPTGFDY (SEQ ID NO: 41)) and the light chain CDRsequences CDR1 (RASENIYSNLA (SEQ ID NO: 42)), CDR2 (AASNLAD (SEQ ID NO:43)), and CDR3 (QHFWTTPWA (SEQ ID NO: 44)), attached to human antibodyFR and constant region sequences. In more preferred embodiments, one ormore murine FR amino acid residues are substituted for the correspondinghuman FR residues, particularly at locations adjacent to or nearby theCDR residues. Exemplary murine V_(H) residues that may be substituted inthe humanized design are at positions: F27, K38, K46, A68 and F91.Exemplary murine V_(L) residues that may be substituted in the humanizeddesign are at positions R37, K39, V48, F49, and G1. Further details forhumanizing antibody sequences, while retaining the antigenic specificityof the original non-human antibody, are disclosed in the Examples below.

A particularly preferred form of hL243 antibody is illustrated in FIG. 3and FIG. 4, incorporating FR sequences from the human RF-TS3, NEWM andREI antibodies. However, in other embodiments, the FR residues may bederived from any suitable human immunoglobulin, provided that thehumanized antibody can fold such that it retains the ability tospecifically bind HLA-DR. Preferably the type of human framework (FR)used is of the same/similar class/type as the donor antibody. Morepreferably, the human FR sequences are selected to have a high degree ofsequence homology with the corresponding murine FR sequences,particularly at positions spatially close or adjacent to the CDRs. Inaccordance with this embodiment, the frameworks (ie, FR1-4) of thehumanized L243 V_(H) or V_(L) may be derived from a combination of humanantibodies. Examples of human frameworks which may be used to constructCDR-grafted humanized antibodies are LAY, POM, TUR, TEI, KOL, NEWM, REI,RF and EU. Preferably human RF-TS3 FR1-3 and NEWM FR4 are used for theheavy chain and REI FR1-4 are used for the light chain. The variabledomain residue numbering system used herein is described in Kabat et al,(1991), Sequences of Proteins of Immunological Interest, 5th Edition,United States Department of Health and Human Services

The light and heavy chain variable domains of the humanized antibodymolecule may be fused to human light or heavy chain constant domains.The human constant domains may be selected with regard to the proposedfunction of the antibody. In one embodiment, the human constant domainsmay be selected based on a lack of effector functions. The heavy chainconstant domains fused to the heavy chain variable region may be thoseof human IgA (α1 or α2 chain), IgG (γ1, γ2, γ3 or γ4 chain) or IgM (μchain). The light chain constant domains which may be fused to the lightchain variable region include human lambda and kappa chains.

In one particular embodiment of the present invention, a γ1 chain isused. In yet another particular embodiment, a γ4 chain is used. The useof the γ4 chain may in some cases increase the tolerance to hL243 insubjects (decreased side effects and infusion reactions, etc).

In one embodiment, analogues of human constant domains may be used.These include but are not limited to those constant domains containingone or more additional amino acids than the corresponding human domainor those constant domains wherein one or more existing amino acids ofthe corresponding human domain have been deleted or altered. Suchdomains may be obtained, for example, by oligonucleotide directedmutagenesis.

In a particular embodiment, an anti-HLA-DR antibody or fragment thereofmay be a fusion protein. The fusion protein may contain one or moreanti-HLA-DR antibodies or fragments thereof. In various embodiments, thefusion protein may also comprise one or more additional antibodiesagainst a different antigen, or may comprise a different effectorprotein or peptide, such as a cytokine. For example, the differentantigen may be a tumor marker selected from a B cell lineage antigen,(eg, CD19, CD20, or CD22) for the treatment of B cell malignancies. Inanother example, the different antigen may be expressed on other cellsthat cause other types of malignancies. Further, the cell marker may bea non-B cell lineage antigen, such as selected from the group consistingof HLA-DR, CD3, CD33, CD52, CD66, MUC1 and TAC.

In one embodiment, an anti-HLA-DR antibody may be combined with otherantibodies and used to treat a subject having or suspected of developinga disease. In accordance with this embodiment, an anti-HLA-DR antibodyor fragment thereof may be combined with an anticancer monoclonalantibody such as a humanized monoclonal antibody (eg hA20, anti-CD20Mab) and used to treat cancer. It is contemplated herein that ananti-HLA-DR antibody may be used as a separate antibody composition incombination with one or more other separate antibody compositions, orused as a bi-functional antibody containing, for example, oneanti-HLA-DR and one other anti-tumor antibody, such as hA20. In anotherparticular embodiment, the antibody may target a B cell malignancy. TheB cell malignancy may consist of indolent forms of B cell lymphomas,aggressive forms of B cell lymphomas, chronic lymphatic leukemias, acutelymphatic leukemias, Waldenstrom's macroglobulinemia, and multiplemyeloma. Other non-malignant B cell disorders and related diseases thatmay be treated with the subject antibodies include many autoimmune andimmune dysregulatory diseases, such as septicemia and septic shock.

Antibodies and Antibody Fragments

Techniques for preparing monoclonal antibodies against virtually anytarget antigen are well known in the art. See, for example, Kohler andMilstein, Nature 256: 495 (1975), and Coligan et al. (eds.), CURRENTPROTOCOLS IN IMMUNOLOGY, VOL. 1, pages 2.5.1-2.6.7 (John Wiley & Sons1991). Briefly, monoclonal antibodies can be obtained by injecting micewith a composition comprising an antigen, removing the spleen to obtainB-lymphocytes, fusing the B-lymphocytes with myeloma cells to producehybridomas, cloning the hybridomas, selecting positive clones whichproduce antibodies to the antigen, culturing the clones that produceantibodies to the antigen, and isolating the antibodies from thehybridoma cultures. In preferred embodiments, the antigen is a humanantigen.

MAbs can be isolated and purified from hybridoma cultures by a varietyof well-established techniques. Such isolation techniques includeaffinity chromatography with Protein-A Sepharose, size-exclusionchromatography, and ion-exchange chromatography. See, for example,Coligan at pages 2.7.1-2.7.12 and pages 2.9.1-2.9.3. Also, see Baines etal., “Purification of Immunoglobulin G (IgG),” in METHODS IN MOLECULARBIOLOGY, VOL. 10, pages 79-104 (The Humana Press, Inc. 1992).

After the initial raising of antibodies to the immunogen, the antibodiescan be sequenced and subsequently prepared by recombinant techniques.Humanization and chimerization of murine antibodies and antibodyfragments are well known to those skilled in the art. The use ofantibody components derived from humanized, chimeric or human antibodiesobviates potential problems associated with the immunogenicity of murineconstant regions.

Chimeric Antibodies

A chimeric antibody is a recombinant protein in which the variableregions of a human antibody have been replaced by the variable regionsof, for example, a mouse antibody, including thecomplementarity-determining regions (CDRs) of the mouse antibody.Chimeric antibodies exhibit decreased immunogenicity and increasedstability when administered to a subject. General techniques for cloningmurine immunoglobulin variable domains are disclosed, for example, inOrlandi et al., Proc. Nat'l Acad. Sci. USA 86: 3833 (1989). Techniquesfor constructing chimeric antibodies are well known to those of skill inthe art. As an example, Leung et al., Hybridoma 13:469 (1994), producedan LL2 chimera by combining DNA sequences encoding the V_(κ) and V_(H)domains of murine LL2, an anti-CD22 monoclonal antibody, with respectivehuman κ and IgG₁ constant region domains.

Humanized Antibodies

Techniques for producing humanized MAbs are well known in the art (see,e.g., Jones et al., Nature 321: 522 (1986), Riechmann et al., Nature332: 323 (1988), Verhoeyen et al., Science 239: 1534 (1988), Carter etal., Proc. Nat'l Acad. Sci. USA 89: 4285 (1992), Sandhu, Crit. Rev.Biotech. 12: 437 (1992), and Singer et al., J. Immun. 150: 2844 (1993)).A chimeric or murine monoclonal antibody may be humanized bytransferring the mouse CDRs from the heavy and light variable chains ofthe mouse immunoglobulin into the corresponding variable domains of ahuman antibody. The mouse framework regions (FR) in the chimericmonoclonal antibody are also replaced with human FR sequences. As simplytransferring mouse CDRs into human FRs often results in a reduction oreven loss of antibody affinity, additional modification might berequired in order to restore the original affinity of the murineantibody. This can be accomplished by the replacement of one or morehuman residues in the FR regions with their murine counterparts toobtain an antibody that possesses good binding affinity to its epitope.See, for example, Tempest et al., Biotechnology 9:266 (1991) andVerhoeyen et al., Science 239: 1534 (1988). Generally, those human FRamino acid residues that differ from their murine counterparts and arelocated close to or touching one or more CDR amino acid residues wouldbe candidates for substitution.

Human Antibodies

Methods for producing fully human antibodies using either combinatorialapproaches or transgenic animals transformed with human immunoglobulinloci are known in the art (e.g., Mancini et al., 2004, New Microbiol.27:315-28; Conrad and Scheller, 2005, Comb. Chem. High ThroughputScreen. 8:117-26; Brekke and Loset, 2003, Curr. Opin. Phamacol.3:544-50). A fully human antibody also can be constructed by genetic orchromosomal transfection methods, as well as phage display technology,all of which are known in the art. See for example, McCafferty et al.,Nature 348:552-553 (1990). Such fully human antibodies are expected toexhibit even fewer side effects than chimeric or humanized antibodiesand to function in vivo as essentially endogenous human antibodies. Incertain embodiments, the claimed methods and procedures may utilizehuman antibodies produced by such techniques.

In one alternative, the phage display technique may be used to generatehuman antibodies (e.g., Dantas-Barbosa et al., 2005, Genet. Mol. Res.4:126-40). Human antibodies may be generated from normal humans or fromhumans that exhibit a particular disease state, such as cancer(Dantas-Barbosa et al., 2005). The advantage to constructing humanantibodies from a diseased individual is that the circulating antibodyrepertoire may be biased towards antibodies against disease-associatedantigens.

In one non-limiting example of this methodology, Dantas-Barbosa et al.(2005) constructed a phage display library of human Fab antibodyfragments from osteosarcoma patients. Generally, total RNA was obtainedfrom circulating blood lymphocytes (Id.). Recombinant Fab were clonedfrom the μ, γ and κ chain antibody repertoires and inserted into a phagedisplay library (Id.). RNAs were converted to cDNAs and used to make FabcDNA libraries using specific primers against the heavy and light chainimmunoglobulin sequences (Marks et al., 1991, J Mol. Biol. 222:581-97).Library construction was performed according to Andris-Widhopf et al.(2000, In: Phage Display Laboratory Manual, Barbas et al. (eds), 1^(st)edition, Cold Spring Harbor Laboratory Press, Cold Spring Harbor, N.Y.pp. 9.1 to 9.22). The final Fab fragments were digested with restrictionendonucleases and inserted into the bacteriophage genome to make thephage display library. Such libraries may be screened by standard phagedisplay methods, as known in the art (see, e.g., Pasqualini andRuoslahti, 1996, Nature 380:364-366; Pasqualini, 1999, The Quart. J.Nucl. Med. 43:159-162).

Phage display can be performed in a variety of formats, for theirreview, see e.g. Johnson and Chiswell, Current Opinion in StructuralBiology 3:5564-571 (1993). Human antibodies may also be generated by invitro activated B cells. See U.S. Pat. Nos. 5,567,610 and 5,229,275,incorporated herein by reference in their entirety. The skilled artisanwill realize that these techniques are exemplary and any known methodfor making and screening human antibodies or antibody fragments may beutilized.

In another alternative, transgenic animals that have been geneticallyengineered to produce human antibodies may be used to generateantibodies against essentially any immunogenic target, using standardimmunization protocols. Methods for obtaining human antibodies fromtransgenic mice are disclosed by Green et al., Nature Genet. 7:13(1994), Lonberg et al., Nature 368:856 (1994), and Taylor et al., Int.Immun. 6:579 (1994). A non-limiting example of such a system is theXenoMouse® (e.g., Green et al., 1999, J. Immunol. Methods 231:11-23)from Abgenix (Fremont, Calif.). In the XenoMouse® and similar animals,the mouse antibody genes have been inactivated and replaced byfunctional human antibody genes, while the remainder of the mouse immunesystem remains intact.

The XenoMouse® was transformed with germline-configured YACs (yeastartificial chromosomes) that contained portions of the human IgH andIgkappa loci, including the majority of the variable region sequences,along accessory genes and regulatory sequences. The human variableregion repertoire may be used to generate antibody producing B cells,which may be processed into hybridomas by known techniques. A XenoMouse®immunized with a target antigen will produce human antibodies by thenormal immune response, which may be harvested and/or produced bystandard techniques discussed above. A variety of strains of XenoMouse®are available, each of which is capable of producing a different classof antibody. Transgenically produced human antibodies have been shown tohave therapeutic potential, while retaining the pharmacokineticproperties of normal human antibodies (Green et al., 1999). The skilledartisan will realize that the claimed compositions and methods are notlimited to use of the XenoMouse® system but may utilize any transgenicanimal that has been genetically engineered to produce human antibodies.

Antibody Fragments

Antibody fragments which recognize specific epitopes can be generated byknown techniques. Antibody fragments are antigen binding portions of anantibody, such as F(ab)₂, Fab′, F(ab)₂, Fab, Fv, sFv and the like.F(ab′)₂ fragments can be produced by pepsin digestion of the antibodymolecule and Fab′ fragments can be generated by reducing disulfidebridges of the F(ab′)₂ fragments. Alternatively, Fab′ expressionlibraries can be constructed (Huse et al., 1989, Science, 246:1274-1281)to allow rapid and easy identification of monoclonal Fab′ fragments withthe desired specificity. F(ab)₂ fragments may be generated by papaindigestion of an antibody and Fab fragments obtained by disulfidereduction.

A single chain Fv molecule (scFv) comprises a VL domain and a VH domain.The VL and VH domains associate to form a target binding site. These twodomains are further covalently linked by a peptide linker (L). Methodsfor making scFv molecules and designing suitable peptide linkers aredescribed in U.S. Pat. No. 4,704,692, U.S. Pat. No. 4,946,778, R. Raagand M. Whitlow, “Single Chain Fvs.” FASEB Vol 9:73-80 (1995) and R. E.Bird and B. W. Walker, “Single Chain Antibody Variable Regions,”TIBTECH, Vol 9: 132-137 (1991).

Techniques for producing single domain antibodies (DABs) are also knownin the art, as disclosed for example in Cossins et al. (2006, ProtExpress Purif 51:253-259), incorporated herein by reference.

An antibody fragment can be prepared by proteolytic hydrolysis of thefull length antibody or by expression in E. coli or another host of theDNA coding for the fragment. An antibody fragment can be obtained bypepsin or papain digestion of full length antibodies by conventionalmethods. These methods are described, for example, by Goldenberg, U.S.Pat. Nos. 4,036,945 and 4,331,647 and references contained therein.Also, see Nisonoff et al., Arch Biochem. Biophys. 89: 230 (1960);Porter, Biochem. J. 73: 119 (1959), Edelman et al., in METHODS INENZYMOLOGY VOL. 1, page 422 (Academic Press 1967), and Coligan at pages2.8.1-2.8.10 and 2.10.-2.10.4.

Known Antibodies

Antibodies of use may be commercially obtained from a wide variety ofknown sources. For example, a variety of antibody secreting hybridomalines are available from the American Type Culture Collection (ATCC,Manassas, Va.). A large number of antibodies against various diseasetargets, including but not limited to tumor-associated antigens, havebeen deposited at the ATCC and/or have published variable regionsequences and are available for use in the claimed methods andcompositions. See, e.g., U.S. Pat. Nos. 7,312,318; 7,282,567; 7,151,164;7,074,403; 7,060,802; 7,056,509; 7,049,060; 7,045,132; 7,041,803;7,041,802; 7,041,293; 7,038,018; 7,037,498; 7,012,133; 7,001,598;6,998,468; 6,994,976; 6,994,852; 6,989,241; 6,974,863; 6,965,018;6,964,854; 6,962,981; 6,962,813; 6,956,107; 6,951,924; 6,949,244;6,946,129; 6,943,020; 6,939,547; 6,921,645; 6,921,645; 6,921,533;6,919,433; 6,919,078; 6,916,475; 6,905,681; 6,899,879; 6,893,625;6,887,468; 6,887,466; 6,884,594; 6,881,405; 6,878,812; 6,875,580;6,872,568; 6,867,006; 6,864,062; 6,861,511; 6,861,227; 6,861,226;6,838,282; 6,835,549; 6,835,370; 6,824,780; 6,824,778; 6,812,206;6,793,924; 6,783,758; 6,770,450; 6,767,711; 6,764,688; 6,764,681;6,764,679; 6,743,898; 6,733,981; 6,730,307; 6,720,155; 6,716,966;6,709,653; 6,693,176; 6,692,908; 6,689,607; 6,689,362; 6,689,355;6,682,737; 6,682,736; 6,682,734; 6,673,344; 6,653,104; 6,652,852;6,635,482; 6,630,144; 6,610,833; 6,610,294; 6,605,441; 6,605,279;6,596,852; 6,592,868; 6,576,745; 6,572,856; 6,566,076; 6,562,618;6,545,130; 6,544,749; 6,534,058; 6,528,625; 6,528,269; 6,521,227;6,518,404; 6,511,665; 6,491,915; 6,488,930; 6,482,598; 6,482,408;6,479,247; 6,468,531; 6,468,529; 6,465,173; 6,461,823; 6,458,356;6,455,044; 6,455,040, 6,451,310; 6,444,206; 6,441,143; 6,432,404;6,432,402; 6,419,928; 6,413,726; 6,406,694; 6,403,770; 6,403,091;6,395,276; 6,395,274; 6,387,350; 6,383,759; 6,383,484; 6,376,654;6,372,215; 6,359,126; 6,355,481; 6,355,444; 6,355,245; 6,355,244;6,346,246; 6,344,198; 6,340,571; 6,340,459; 6,331,175; 6,306,393;6,254,868; 6,187,287; 6,183,744; 6,129,914; 6,120,767; 6,096,289;6,077,499; 5,922,302; 5,874,540; 5,814,440; 5,798,229; 5,789,554;5,776,456; 5,736,119; 5,716,595; 5,677,136; 5,587,459; 5,443,953,5,525,338. These are exemplary only and a wide variety of otherantibodies and their hybridomas are known in the art. The skilledartisan will realize that antibody sequences or antibody-secretinghybridomas against almost any disease-associated antigen may be obtainedby a simple search of the ATCC, NCBI and/or USPTO databases forantibodies against a selected disease-associated target of interest. Theantigen binding domains of the cloned antibodies may be amplified,excised, ligated into an expression vector, transfected into an adaptedhost cell and used for protein production, using standard techniqueswell known in the art.

Exemplary antibodies that may be utilized include, but are not limitedto, hR1 (anti-IGF-1R, U.S. patent application Ser. No. 13/688,812, filedNov. 29, 2012), hPAM4 (anti-mucin, U.S. Pat. No. 7,282,567), hA20(anti-CD20, U.S. Pat. No. 7,151,164), hA19 (anti-CD19, U.S. Pat. No.7,109,304), hIMMU31 (anti-AFP, U.S. Pat. No. 7,300,655), hLL1(anti-CD74, U.S. Pat. No. 7,312,318), hLL2 (anti-CD22, U.S. Pat. No.5,789,554), hMu-9 (anti-CSAp, U.S. Pat. No. 7,387,772), hL243(anti-HLA-DR, U.S. Pat. No. 7,612,180), hMN-14 (anti-CEACAM5, U.S. Pat.No. 6,676,924), hMN-15 (anti-CEACAM6, U.S. Pat. No. 8,287,865), hRS7(anti-EGP-1, U.S. Pat. No. 7,238,785), hMN-3 (anti-CEACAM6, U.S. Pat.No. 7,541,440), Ab124 and Ab125 (anti-CXCR4, U.S. Pat. No. 7,138,496),the Examples section of each cited patent or application incorporatedherein by reference. More preferably, the antibody is IMMU-31(anti-AFP), hRS7 (anti-TROP-2), hMN-14 (anti-CEACAM5), hMN-3(anti-CEACAM6), hMN-15 (anti-CEACAM6), hLL1 (anti-CD74), hLL2(anti-CD22), hL243 or IMMU-114 (anti-HLA-DR), hA19 (anti-CD19) or hA20(anti-CD20). As used herein, the terms epratuzumab and hLL2 areinterchangeable, as are the terms veltuzumab and hA20, hL243g4P,hL243gamma4P and IMMU-114.

Alternative antibodies of use include, but are not limited to, abciximab(anti-glycoprotein IIb/IIIa), alemtuzumab (anti-CD52), bevacizumab(anti-VEGF), cetuximab (anti-EGFR), gemtuzumab (anti-CD33), ibritumomab(anti-CD20), panitumumab (anti-EGFR), rituximab (anti-CD20), tositumomab(anti-CD20), trastuzumab (anti-ErbB2), lambrolizumab (anti-PD-1receptor), nivolumab (anti-PD-1 receptor), ipilimumab (anti-CTLA-4),abagovomab (anti-CA-125), adecatumumab (anti-EpCAM), atlizumab(anti-IL-6 receptor), benralizumab (anti-CD125), obinutuzumab (GA101,anti-CD20), CC49 (anti-TAG-72), AB-PG1-XG1-026 (anti-PSMA, U.S. patentapplication Ser. No. 11/983,372, deposited as ATCC PTA-4405 andPTA-4406), D2/B (anti-PSMA, WO 2009/130575), tocilizumab (anti-IL-6receptor), basiliximab (anti-CD25), daclizumab (anti-CD25), efalizumab(anti-CD11a), GA101 (anti-CD20; Glycart Roche), natalizumab(anti-.alpha.4 integrin), omalizumab (anti-IgE); anti-TNF-.alpha.antibodies such as CDP571 (Ofei et al., 2011, Diabetes 45:881-85),MTNFAI, M2TNFAI, M3TNFAI, M3TNFABI, M302B, M303 (Thermo Scientific,Rockford, Ill.), infliximab (Centocor, Malvern, Pa.), certolizumab pegol(UCB, Brussels, Belgium), anti-CD40L (UCB, Brussels, Belgium),adalimumab (Abbott, Abbott Park, Ill.), or Benlysta (Human GenomeSciences).

A comprehensive analysis of suitable antigen (Cluster Designation, orCD) targets on hematopoietic malignant cells, as shown by flow cytometryand which can be a guide to selecting suitable antibodies fordrug-conjugated immunotherapy, is Craig and Foon, Blood prepublishedonline Jan. 15, 2008; DOL 10.1182/blood-2007-11-120535.

The CD66 antigens consist of five different glycoproteins with similarstructures, CD66a-e, encoded by the carcinoembryonic antigen (CEA) genefamily members, BCG, CGM6, NCA, CGM1 and CEA, respectively. These CD66antigens (e.g., CEACAM6) are expressed mainly in granulocytes, normalepithelial cells of the digestive tract and tumor cells of varioustissues. Also included as suitable targets for cancers are cancer testisantigens, such as NY-ESO-1 (Theurillat et al., Int. J. Cancer 2007;120(11):2411-7), as well as CD79a in myeloid leukemia (Kozlov et al.,Cancer Genet. Cytogenet. 2005; 163(1):62-7) and also B-cell diseases,and CD79b for non-Hodgkin's lymphoma (Poison et al., Blood110(2):616-623). A number of the aforementioned antigens are disclosedin U.S. Provisional Application Ser. No. 60/426,379, entitled “Use ofMulti-specific, Non-covalent Complexes for Targeted Delivery ofTherapeutics,” filed Nov. 15, 2002. Cancer stem cells, which areascribed to be more therapy-resistant precursor malignant cellpopulations (Hill and Penis, J. Natl. Cancer Inst. 2007; 99:1435-40),have antigens that can be targeted in certain cancer types, such asCD133 in prostate cancer (Maitland et al., Ernst Schering Found. Sympos.Proc. 2006; 5:155-79), non-small-cell lung cancer (Donnenberg et al., J.Control Release 2007; 122(3):385-91), and glioblastoma (Beier et al.,Cancer Res. 2007; 67(9):4010-5), and CD44 in colorectal cancer (Dalerbaer al., Proc. Natl. Acad. Sci. USA 2007; 104(24)10158-63), pancreaticcancer (Li et al., Cancer Res. 2007; 67(3):1030-7), and in head and necksquamous cell carcinoma (Prince et al., Proc. Natl. Acad. Sci. USA 2007;104(3)973-8).

For multiple myeloma therapy, suitable targeting antibodies have beendescribed against, for example, CD38 and CD138 (Stevenson, Mol Med 2006;12(11-12):345-346; Tassone et al., Blood 2004; 104(12):3688-96), CD74(Stein et al., ibid.), CS1 (Tai et al., Blood 2008; 112(4):1329-37, andCD40 (Tai et al., 2005; Cancer Res. 65(13):5898-5906).

Macrophage migration inhibitory factor (MIF) is an important regulatorof innate and adaptive immunity and apoptosis. It has been reported thatCD74 is the endogenous receptor for MIF (Leng et al., 2003, J Exp Med197:1467-76). The therapeutic effect of antagonistic anti-CD74antibodies on MIF-mediated intracellular pathways may be of use fortreatment of a broad range of disease states, such as cancers of thebladder, prostate, breast, lung, colon and chronic lymphocytic leukemia(e.g., Meyer-Siegler et al., 2004, BMC Cancer 12:34; Shachar & Haran,2011, Leuk Lymphoma 52:1446-54); autoimmune diseases such as rheumatoidarthritis and systemic lupus erythematosus (Morand & Leech, 2005, FrontBiosci 10:12-22; Shachar & Haran, 2011, Leuk Lymphoma 52:1446-54);kidney diseases such as renal allograft rejection (Lan, 2008, NephronExp Nephrol. 109:e79-83); and numerous inflammatory diseases(Meyer-Siegler et al., 2009, Mediators Inflamm epub Mar. 22, 2009;Takahashi et al., 2009, Respir Res 10:33; Milatuzumab (hLL1) is anexemplary anti-CD74 antibody of therapeutic use for treatment ofMIF-mediated diseases.

Anti-TNF-.alpha. antibodies are known in the art and may be of use totreat immune diseases, such as autoimmune disease, immune dysfunction(e.g., graft-versus-host disease, organ transplant rejection) ordiabetes. Known antibodies against TNF-.alpha. include the humanantibody CDP571 (Ofei et al., 2011, Diabetes 45:881-85); murineantibodies MTNFAI, M2TNFAI, M3TNFAI, M3TNFABI, M302B and M303 (ThermoScientific, Rockford, Ill.); infliximab (Centocor, Malvern, Pa.);certolizumab pegol (UCB, Brussels, Belgium); and adalimumab (Abbott,Abbott Park, Ill.). These and many other known anti-TNF-.alpha.antibodies may be used in the claimed methods and compositions. Otherantibodies of use for therapy of immune dysregulatory or autoimmunedisease include, but are not limited to, anti-B-cell antibodies such asveltuzumab, epratuzumab, milatuzumab or hL243; tocilizumab (anti-IL-6receptor); basiliximab (anti-CD25); daclizumab (anti-CD25); efalizumab(anti-CD11a); muromonab-CD3 (anti-CD3 receptor); anti-CD40L (UCB,Brussels, Belgium); natalizumab (anti-.alpha.4 integrin) and omalizumab(anti-IgE).

Studies with checkpoint inhibitor antibodies for cancer therapy havegenerated unprecedented response rates in cancers previously thought tobe resistant to cancer treatment (see, e.g., Ott & Bhardwaj, 2013,Frontiers in Immunology 4:346; Menzies & Long, 2013, Ther Adv Med Oncol5:278-85; Pardoll, 2012, Nature Reviews 12:252-264; Mavilio & Lugli,).Therapy with antagonistic checkpoint blocking antibodies against CTLA-4,PD-1 and PD-Ll are one of the most promising new avenues ofimmunotherapy for cancer and other diseases. In contrast to the majorityof anti-cancer agents, checkpoint inhibitor do not target tumor cellsdirectly, but rather target lymphocyte receptors or their ligands inorder to enhance the endogenous antitumor activity of the immune system.(Pardoll, 2012, Nature Reviews 12:252-264) Because such antibodies actprimarily by regulating the immune response to diseased cells, tissuesor pathogens, they may be used in combination with other therapeuticmodalities, such as the subject anti-HLA-DR antibodies, to enhance theiranti-tumor effect.

Programmed cell death protein 1 (PD-1, also known as CD279) encodes acell surface membrane protein of the immunoglobulin superfamily, whichis expressed in B cells and NK cells (Shinohara et al., 1995, Genomics23:704-6; Blank et al., 2007, Cancer Immunol Immunother 56:739-45;Finger et al., 1997, Gene 197:177-87; Pardoll, 2012, Nature Reviews12:252-264). Anti-PD1 antibodies have been used for treatment ofmelanoma, non-small-cell lung cancer, bladder cancer, prostate cancer,colorectal cancer, head and neck cancer, triple-negative breast cancer,leukemia, lymphoma and renal cell cancer (Topalian et al., 2012, N EnglJ Med 366:2443-54; Lipson et al., 2013, Clin Cancer Res 19:462-8; Bergeret al., 2008, Clin Cancer Res 14:3044-51; Gildener-Leapman et al., 2013,Oral Oncol 49:1089-96; Menzies & Long, 2013, Ther Adv Med Oncol5:278-85).

Exemplary anti-PD1 antibodies include lambrolizumab (MK-3475, MERCK),nivolumab (BMS-936558, BRISTOL-MYERS SQUIBB), and pidilizumab (CT-011,CURETECH LTD.). Anti-PD1 antibodies are commercially available, forexample from ABCAM® (AB137132), BIOLEGEND® (EH12.2H7, RMP1-14) andAFFYMETRIX EBIOSCIENCE (J105, J116, MIH4).

Programmed cell death 1 ligand 1 (PD-L1, also known as CD274) is aligand for PD-1, found on activated T cells, B cells, myeloid cells andmacrophages. The complex of PD-1 and PD-L1 inhibits proliferation ofCD8+ T cells and reduces the immune response (Topalian et al., 2012, NEngl J Med 366:2443-54; Brahmer et al., 2012, N Eng J Med 366:2455-65).Anti-PDL1 antibodies have been used for treatment of non-small cell lungcancer, melanoma, colorectal cancer, renal-cell cancer, pancreaticcancer, gastric cancer, ovarian cancer, breast cancer, and hematologicmalignancies (Brahmer et al., N Eng J Med 366:2455-65; Ott et al., 2013,Clin Cancer Res 19:5300-9; Radvanyi et al., 2013, Clin Cancer Res19:5541; Menzies & Long, 2013, Ther Adv Med Oncol 5:278-85; Berger etal., 2008, Clin Cancer Res 14:13044-51).

Exemplary anti-PDL1 antibodies include MDX-1105 (MEDAREX), MEDI4736(MEDIMMUNE) MPDL3280A (GENENTECH) and BMS-936559 (BRISTOL-MYERS SQUIBB).Anti-PDL1 antibodies are also commercially available, for example fromAFFYMETRIX EBIOSCIENCE (MIH1).

Cytotoxic T-lymphocyte antigen 4 (CTLA-4, also known as CD152) is also amember of the immunoglobulin superfamily that is expressed exclusivelyon T-cells. CTLA-4 acts to inhibit T cell activation and is reported toinhibit helper T cell activity and enhance regulatory T cellimmunosuppressive activity (Pardoll, 2012, Nature Reviews 12:252-264).Anti-CTL4A antibodies have been used in clinical trials for treatment ofmelanoma, prostate cancer, small cell lung cancer, non-small cell lungcancer (Robert & Ghiringhelli, 2009, Oncologist 14:848-61; Ott et al.,2013, Clin Cancer Res 19:5300; Weber, 2007, Oncologist 12:864-72; Wadaet al., 2013, J Transl Med 11:89).

Exemplary anti-CTLA4 antibodies include ipilimumab (Bristol-MyersSquibb) and tremelimumab (PFIZER). Anti-PD1 antibodies are commerciallyavailable, for example from ABCAM® (AB134090), SINO BIOLOGICAL INC.(11159-H03H, 11159-H08H), and THERMO SCIENTIFIC PIERCE (PA5-29572,PA5-23967, PA5-26465, MA1-12205, MA1-35914). Ipilimumab has recentlyreceived FDA approval for treatment of metastatic melanoma (Wada et al.,2013, J Transl Med 11:89).

These and other known checkpoint inhibitor antibodies may be used incombination with anti-HLA-DR antibodies alone or in further combinationwith an interferon, such as interferon-α, for improved cancer therapy.

The person of ordinary skill will be aware that it is possible togenerate any number of antibodies against a known and well characterizedtarget antigen, such as human HLA-DR. The human HLA-DR antigen has beenwell characterized in the art, for example by its amino acid sequence(see, e.g., GenBank Accession No. ADM15723.1).

Antibody Allotypes

Immunogenicity of therapeutic antibodies is associated with increasedrisk of infusion reactions and decreased duration of therapeuticresponse (Baert et al., 2003, N Engl J Med 348:602-08). The extent towhich therapeutic antibodies induce an immune response in the host maybe determined in part by the allotype of the antibody (Stickler et al.,2011, Genes and Immunity 12:213-21). Antibody allotype is related toamino acid sequence variations at specific locations in the constantregion sequences of the antibody. The allotypes of IgG antibodiescontaining a heavy chain γ-type constant region are designated as Gmallotypes (1976, J Immunol 117:1056-59).

For the common IgG1 human antibodies, the most prevalent allotype isG1m1 (Stickler et al., 2011, Genes and Immunity 12:213-21). However, theG1m3 allotype also occurs frequently in Caucasians (Id.). It has beenreported that G1m1 antibodies contain allotypic sequences that tend toinduce an immune response when administered to non-G1m1 (nG1 m1)recipients, such as G1m3 patients (Id.). Non-G1m1 allotype antibodiesare not as immunogenic when administered to G1m1 patients (Id.).

The human G1m1 allotype comprises the amino acids D12 (Kabat position356) and L14 (Kabat position 358) in the CH3 sequence of the heavy chainIgG1. The nG1m1 allotype comprises the amino acids E12 and M14 at thesame locations. Both G1m1 and nG1m1 allotypes comprise an E13 residue inbetween the two variable sites and the allotypes are sometimes referredto as DEL and EEM allotypes. A non-limiting example of the heavy chainconstant region sequences for G1m1 and nG1m1 allotype antibodies isshown for the exemplary antibodies rituximab (SEQ ID NO:45) andveltuzumab (SEQ ID NO:46).

Rituximab heavy chain variable region sequence (SEQ ID NO: 45)ASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKKAEPKSCDKTHTCPPCPAPELLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQPREPQVYTLPPSRDELTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK Veltuzumab heavy chain variable region(SEQ ID NO: 46) ASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCPPCPAPELLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQPREPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFELYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK

With regard to therapeutic antibodies, veltuzumab and rituximab are,respectively, humanized and chimeric IgG1 antibodies against CD20, ofuse for therapy of a wide variety of hematological malignancies and/orautoimmune diseases. Table 1 compares the allotype sequences ofrituximab vs. veltuzumab. As shown in Table 1, rituximab (G1m17,1) is aDEL allotype IgG1, with an additional sequence variation at Kabatposition 214 (heavy chain CH1) of lysine in rituximab vs. arginine inveltuzumab. It has been reported that veltuzumab is less immunogenic insubjects than rituximab (see, e.g., Morchhauser et al., 2009, J ClinOncol 27:3346-53; Goldenberg et al., 2009, Blood 113:1062-70; Robak &Robak, 2011, BioDrugs 25:13-25), an effect that has been attributed tothe difference between humanized and chimeric antibodies. However, thedifference in allotypes between the EEM and DEL allotypes likely alsoaccounts for the lower immunogenicity of veltuzumab.

TABLE 1 Allotypes of Rituximab vs. Veltuzumab Complete Heavy chainposition and associated allotypes allotype 214 (allotype) 356/358(allotype) 431 (allotype) Rituximab G1m17,1 K 17 D/L 1 A — VeltuzumabG1m3 R 3 E/M — A —

In order to reduce the immunogenicity of therapeutic antibodies inindividuals of nG1m1 genotype, it is desirable to select the allotype ofthe antibody to correspond to the EEM allotype, with a glutamate residueat Kabat position 356, a methionine at Kabat position 358, andpreferably an arginine residue at Kabat position 214. Surprisingly, itwas found that repeated subcutaneous administration of G1m3 antibodiesover a long period of time did not result in a significant immuneresponse.

Bi-Specific Antibodies

In certain embodiments, the anti-HLA-DR antibodies disclosed herein maybe used in combination with another molecule attached to the antibody.Attachment may be either covalent or non-covalent. In some embodiments,an anti-HLA-DR antibody may be used in a bi-specific antibody, i.e., anantibody that has two different binding sites, one for HLA-DR antibodyand another for a different target antigen, such as a hapten or adisease-associated antigen. Methods for construction and use ofbi-specific and multi-specific antibodies are disclosed, for example, inU.S. Pat. Nos. 6,962,702; 7,074,405; 7,230,084; 7,300,644; 7,429,381 and7,563,439, the Examples section of each of which is incorporated hereinby reference.

Where the bi-specific antibody is targeted in part against atumor-associated antigen, exemplary types of tumors that may be targetedinclude acute lymphoblastic leukemia, acute myelogenous leukemia,biliary cancer, breast cancer, cervical cancer, chronic lymphocyticleukemia, chronic myelogenous leukemia, colorectal cancer, endometrialcancer, esophageal, gastric, head and neck cancer, Hodgkin's lymphoma,lung cancer, medullary thyroid, non-Hodgkin's lymphoma, ovarian cancer,pancreatic cancer, glioma, melanoma, liver cancer, prostate cancer, andurinary bladder cancer Preferred are tumors that have constitutiveexpression of HLA-DR.

Pre-Targeting

One strategy for use of bi-specific antibodies includes pretargetingmethodologies, in which therapeutic agent attached to a targetableconstruct is administered to a subject after a bi-specific antibody hasbeen administered. Pretargeting methods have been developed to increasethe target:background ratios of detection or therapeutic agents Examplesof pre-targeting and biotin/avidin approaches are described, forexample, in Goodwin et al, U.S. Pat. No. 4,863,713; Goodwin et al, JNucl Med 29:226, 1988; Hnatowich et al, J Nucl Med 28:1294, 1987; Oehret al, J Nucl Med 29:728, 1988; Klibanov et al, J Nucl Med 29:1951,1988; Sinitsyn et al, J Nucl Med 3:66, 1989; Kalofonos et al, J Nucl Med31:1791, 199; Schechter et al, Int J Cancer 48:167, 1991; Paganelli etal, Cancer Res 51:596, 1991; Paganelli et al, Nucl Med Commun 12:211,1991; U.S. Pat. No. 5,256,395; Stickney et al, Cancer Res 51:665, 1991;Yuan et al, Cancer Res 51:3119, 1991; U.S. Pat. No. 6,77,499; U.S. Pat.No. 6,472,511; the Examples section of each of which is incorporatedherein by reference.

In certain embodiments, bispecific antibodies and targetable constructsmay be of use in treating and/or imaging normal or diseased tissue andorgans, for example using the methods described in U.S. Pat. Nos.6,126,916; 5,772,981; 5,746,996; 5,328,679; and 5,128,119, eachincorporated herein by reference.

Immunoconjugates

In certain embodiments, the anti-HLA-DR antibody or fragment may beconjugated to one or more therapeutic or diagnostic agents. Thetherapeutic agents do not need to be the same but can be different, e.g.a drug and a radioisotope. For example, ¹³¹I can be incorporated into atyrosine of an antibody or fusion protein and a drug attached to anepsilon amino group of a lysine residue. Therapeutic and diagnosticagents also can be attached, for example to reduced SH groups and/or tocarbohydrate side chains. Many methods for making covalent ornon-covalent conjugates of therapeutic or diagnostic agents withantibodies or fusion proteins are known in the art and any such knownmethod may be utilized.

A therapeutic or diagnostic agent can be attached at the hinge region ofa reduced antibody component via disulfide bond formation.Alternatively, such agents can be attached using a heterobifunctionalcross-linker, such as N-succinyl 3-(2-pyridyldithio)propionate (SPDP).Yu et al., Int. J. Cancer 56: 244 (1994). General techniques for suchconjugation are well-known in the art. See, for example, Wong, CHEMISTRYOF PROTEIN CONJUGATION AND CROSSLINKING (CRC Press 1991); Upeslacis etal., “Modification of Antibodies by Chemical Methods,” in MONOCLONALANTIBODIES: PRINCIPLES AND APPLICATIONS, Birch et al. (eds.), pages187-230 (Wiley-Liss, Inc. 1995); Price, “Production and Characterizationof Synthetic Peptide-Derived Antibodies,” in MONOCLONAL ANTIBODIES:PRODUCTION, ENGINEERING AND CLINICAL APPLICATION, Ritter et al. (eds.),pages 60-84 (Cambridge University Press 1995). Alternatively, thetherapeutic or diagnostic agent can be conjugated via a carbohydratemoiety in the Fc region of the antibody. The carbohydrate group can beused to increase the loading of the same agent that is bound to a thiolgroup, or the carbohydrate moiety can be used to bind a differenttherapeutic or diagnostic agent.

Methods for conjugating peptides to antibody components via an antibodycarbohydrate moiety are well-known to those of skill in the art. See,for example, Shih et al., Int. J. Cancer 41: 832 (1988); Shih et al.,Int. J. Cancer 46: 1101 (1990); and Shih et al., U.S. Pat. No.5,057,313, incorporated herein in their entirety by reference. Thegeneral method involves reacting an antibody component having anoxidized carbohydrate portion with a carrier polymer that has at leastone free amine function. This reaction results in an initial Schiff base(imine) linkage, which can be stabilized by reduction to a secondaryamine to form the final conjugate.

The Fc region may be absent if the antibody used as the antibodycomponent of the immunoconjugate is an antibody fragment. However, it ispossible to introduce a carbohydrate moiety into the light chainvariable region of a full length antibody or antibody fragment. See, forexample, Leung et al., J. Immunol. 154: 5919 (1995); Hansen et al., U.S.Pat. No. 5,443,953 (1995), Leung et al., U.S. Pat. No. 6,254,868,incorporated herein by reference in their entirety. The engineeredcarbohydrate moiety is used to attach the therapeutic or diagnosticagent.

In some embodiments, a chelating agent may be attached to an antibody,antibody fragment or fusion protein and used to chelate a therapeutic ordiagnostic agent, such as a radionuclide. Exemplary chelators includebut are not limited to DTPA (such as Mx-DTPA), DOTA, TETA, NETA or NOTA.Methods of conjugation and use of chelating agents to attach metals orother ligands to proteins are well known in the art (see, e.g., U.S.patent application Ser. No. 12/112,289, incorporated herein by referencein its entirety).

In certain embodiments, radioactive metals or paramagnetic ions may beattached to proteins or peptides by reaction with a reagent having along tail, to which may be attached a multiplicity of chelating groupsfor binding ions. Such a tail can be a polymer such as a polylysine,polysaccharide, or other derivatized or derivatizable chains havingpendant groups to which can be bound chelating groups such as, e.g.,ethylenediaminetetraacetic acid (EDTA), diethylenetriaminepentaaceticacid (DTPA), porphyrins, polyamines, crown ethers,bis-thiosemicarbazones, polyoximes, and like groups known to be usefulfor this purpose.

Chelates may be directly linked to antibodies or peptides, for exampleas disclosed in U.S. Pat. No. 4,824,659, incorporated herein in itsentirety by reference. Particularly useful metal-chelate combinationsinclude 2-benzyl-DTPA and its monomethyl and cyclohexyl analogs, usedwith diagnostic isotopes in the general energy range of 60 to 4,000 keV,such as ¹²⁵I, ¹³¹I, ¹²³I, ¹²⁴I, ⁶²Cu, ⁶⁴CU, ¹⁸F, ¹¹¹In, ⁶⁷Ga, ⁶⁸Ga,^(99m)Tc, ^(94m)Tc, ¹¹C, ¹³N, ¹⁵O, ⁷⁶Br, for radioimaging. The samechelates, when complexed with non-radioactive metals, such as manganese,iron and gadolinium are useful for MM. Macrocyclic chelates such asNOTA, DOTA, and TETA are of use with a variety of metals andradiometals, most particularly with radionuclides of gallium, yttriumand copper, respectively. Such metal-chelate complexes can be made verystable by tailoring the ring size to the metal of interest. Otherring-type chelates such as macrocyclic polyethers, which are of interestfor stably binding nuclides, such as ²²³Ra for RAIT are encompassed.

More recently, methods of ¹⁸F-labeling of use in PET scanning techniqueshave been disclosed, for example by reaction of F-18 with a metal orother atom, such as aluminum. The ¹⁸F-Al conjugate may be complexed withchelating groups, such as DOTA, NOTA or NETA that are attached directlyto antibodies or used to label targetable constructs in pre-targetingmethods. Such F-18 labeling techniques are disclosed in U.S. patentapplication Ser. No. 12/112,289, filed Apr. 30, 2008, the entire text ofwhich is incorporated herein by reference.

Therapeutic Agents

In alternative embodiments, therapeutic agents such as cytotoxic agents,anti-angiogenic agents, pro-apoptotic agents, antibiotics, hormones,hormone antagonists, chemokines, drugs, prodrugs, toxins, enzymes,Bruton kinase inhibitors, PI3K inhibitors or other agents may be used,either conjugated to the subject anti-HLA-DR antibodies or separatelyadministered before, simultaneously with, or after the antibody. Drugsof use may possess a pharmaceutical property selected from the groupconsisting of antimitotic, antikinase, alkylating, antimetabolite,antibiotic, alkaloid, anti-angiogenic, pro-apoptotic agents andcombinations thereof.

Exemplary drugs of use may include 5-fluorouracil, aplidin, azaribine,anastrozole, anthracyclines, bendamustine, bleomycin, bortezomib,bryostatin-1, busulfan, calicheamycin, camptothecin, carboplatin,10-hydroxycamptothecin, carmustine, celebrex, chlorambucil, cisplatin(CDDP), Cox-2 inhibitors, irinotecan (CPT-11), SN-38, carboplatin,cladribine, camptothecans, cyclophosphamide, cytarabine, dacarbazine,docetaxel, dactinomycin, daunorubicin, doxorubicin,2-pyrrolinodoxorubicine (2P-DOX), cyano-morpholino doxorubicin,doxorubicin glucuronide, epirubicin glucuronide, estramustine,epipodophyllotoxin, estrogen receptor binding agents, etoposide (VP16),etoposide glucuronide, etoposide phosphate, floxuridine (FUdR),3′,5′-O-dioleoyl-FudR (FUdR-dO), fludarabine, flutamide,farnesyl-protein transferase inhibitors, gemcitabine, hydroxyurea,idarubicin, ifosfamide, L-asparaginase, lenolidamide, leucovorin,lomustine, mechlorethamine, melphalan, mercaptopurine, 6-mercaptopurine,methotrexate, mitoxantrone, mithramycin, mitomycin, mitotane, navelbine,nitrosurea, plicomycin, procarbazine, paclitaxel, pentostatin, PSI-341,raloxifene, semustine, streptozocin, tamoxifen, taxol, temazolomide (anaqueous form of DTIC), transplatinum, thalidomide, thioguanine,thiotepa, teniposide, topotecan, uracil mustard, vinorelbine,vinblastine, vincristine and vinca alkaloids.

Toxins of use may include ricin, abrin, alpha toxin, saporin,ribonuclease (RNase), e.g., onconase, DNase I, Staphylococcalenterotoxin-A, pokeweed antiviral protein, gelonin, diphtheria toxin,Pseudomonas exotoxin, and Pseudomonas endotoxin.

Chemokines of use may include RANTES, MCAF, MIP1-alpha, MIP1-Beta andIP-10.

In certain embodiments, anti-angiogenic agents, such as angiostatin,baculostatin, canstatin, maspin, anti-VEGF antibodies, anti-P1GFpeptides and antibodies, anti-vascular growth factor antibodies,anti-Flk-1 antibodies, anti-Flt-1 antibodies and peptides, anti-Krasantibodies, anti-cMET antibodies, anti-MIF (macrophagemigration-inhibitory factor) antibodies, laminin peptides, fibronectinpeptides, plasminogen activator inhibitors, tissue metalloproteinaseinhibitors, interferons, interleukin-12, IP-10, Gro-β, thrombospondin,2-methoxyoestradiol, proliferin-related protein, carboxiamidotriazole,CM101, Marimastat, pentosan polysulphate, angiopoietin-2,interferon-alpha, herbimycin A, PNU145156E, 16K prolactin fragment,Linomide (roquinimex), thalidomide, pentoxifylline, genistein, TNP-470,endostatin, paclitaxel, accutin, angiostatin, cidofovir, vincristine,bleomycin, AGM-1470, platelet factor 4 or minocycline may be of use.

Immunomodulators of use may be selected from a cytokine, a stem cellgrowth factor, a lymphotoxin, an hematopoietic factor, a colonystimulating factor (CSF), an interferon (IFN), erythropoietin,thrombopoietin and a combination thereof. Specifically useful arelymphotoxins such as tumor necrosis factor (TNF), hematopoietic factors,such as interleukin (IL), colony stimulating factor, such asgranulocyte-colony stimulating factor (G-CSF) or granulocytemacrophage-colony stimulating factor (GM-CSF), interferon, such asinterferons-α, -β or -γ, and stem cell growth factor, such as thatdesignated “S1 factor”. Included among the cytokines are growth hormonessuch as human growth hormone, N-methionyl human growth hormone, andbovine growth hormone; parathyroid hormone; thyroxine; insulin;proinsulin; relaxin; prorelaxin; glycoprotein hormones such as folliclestimulating hormone (FSH), thyroid stimulating hormone (TSH), andluteinizing hormone (LH); hepatic growth factor; prostaglandin,fibroblast growth factor; prolactin; placental lactogen, OB protein;tumor necrosis factor-α and -β; mullerian-inhibiting substance; mousegonadotropin-associated peptide; inhibin; activin; vascular endothelialgrowth factor; integrin; thrombopoietin (TPO); nerve growth factors suchas NGF-β; platelet-growth factor; transforming growth factors (TGFs)such as TGF-α and TGF-β; insulin-like growth factor-I and -II;erythropoietin (EPO); osteoinductive factors; interferons such asinterferon-α, -β, and -γ; colony stimulating factors (CSFs) such asmacrophage-CSF (M-CSF); interleukins (ILs) such as IL-1, IL-1α, IL-2,IL-3, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-11, IL-12; IL-13,IL-14, IL-15, IL-16, IL-17, IL-18, IL-21, IL-25, LIF, kit-ligand orFLT-3, angiostatin, thrombospondin, endostatin, tumor necrosis factorand LT.

Radionuclides of use include, but are not limited to—¹¹¹In, ¹⁷⁷Lu,²¹²Bi, ²¹³Bi, ²¹¹At, ⁶²Cu, ⁶⁷Cu, ⁹⁰Y, ¹²⁵I, ¹³¹I, ³²P, ³³P, ⁴⁷Sc, ¹¹¹Ag,⁶⁷Ga, ¹⁴²Pr, ¹⁵³Sm, ¹⁶¹Tb, ¹⁶⁶Dy, ¹⁶⁶Ho, ¹⁸⁶Re, ¹⁸⁸Re, ¹⁸⁹Re, ²¹²Pb,²²³Ra, ²²⁵Ac, ²²⁷Th, ⁵⁹Fe, ⁷⁵Se, ⁷⁷As, ⁸⁹Sr, ⁹⁹Mo, ¹⁰⁵Rh, ¹⁰⁹Pd, ¹⁴³Pr,¹⁴⁹Pm, ¹⁶⁹Er, ¹⁹⁴Ir, ¹⁹⁸Au, ¹⁹⁹Au, and ²¹¹Pb. The therapeuticradionuclide preferably has a decay-energy in the range of 20 to 6,000keV, preferably in the ranges 60 to 200 keV for an Auger emitter,100-2,500 keV for a beta emitter, and 4,000-6,000 keV for an alphaemitter. Maximum decay energies of useful beta-particle-emittingnuclides are preferably 20-5,000 keV, more preferably 100-4,000 keV, andmost preferably 500-2,500 keV. Also preferred are radionuclides thatsubstantially decay with Auger-emitting particles. For example, Co-58,Ga-67, Br-80m, Tc-99m, Rh-103m, Pt-109, In-111, Sb-119, 1-125, Ho-161,Os-189m and Ir-192. Decay energies of useful beta-particle-emittingnuclides are preferably <1,000 keV, more preferably <100 keV, and mostpreferably <70 keV. Also preferred are radionuclides that substantiallydecay with generation of alpha-particles. Such radionuclides include,but are not limited to: Dy-152, At-211, Bi-212, Ra-223, Rn-219, Po-215,Bi-211, Ac-225, Fr-221, At-217, Bi-213, Th-227 and Fm-255. Decayenergies of useful alpha-particle-emitting radionuclides are preferably2,000-10,000 keV, more preferably 3,000-8,000 keV, and most preferably4,000-7,000 keV. Additional potential radioisotopes of use include ¹¹C,¹³N, ¹⁵O, ⁷⁵Br, ¹⁹⁸Au, ²²⁴Ac, ¹²⁶I, ¹³³I, ⁷⁷Br, ^(113m)In, ⁹⁵Ru, ⁹⁷Ru,¹⁰³Ru, ¹⁰⁵Ru, ¹⁰⁷Hg, ²⁰³Hg, ^(121m)Te, ^(122m)Te, ^(125m)Te, ¹⁶⁵Tm,¹⁶⁷Tm, ¹⁶⁸Tm, ¹⁹⁷Pt, ¹⁰⁹Pd, ¹⁰⁵Rh, ¹⁴²Pr, ¹⁴³Pr, ¹⁶¹Tb, ¹⁶⁶Ho, ¹⁹⁹Au,⁵⁷Co, ⁵⁸Co, ⁵¹Cr, ⁵⁹Fe, ⁷⁵Se, ²⁰¹Tl, ²²⁵Ac, ⁷⁶Br, ¹⁶⁹Yb, and the like.Some useful diagnostic nuclides may include ¹⁸F, ⁵²Fe, ⁶²Cu, ⁶⁴Cu, ⁶⁷Cu,⁶⁷Ga, ⁶⁸Ga, ⁸⁶Y, ⁸⁹Zr, ⁹⁴Tc, ^(99m)Tc, or ¹¹¹In. In certain embodimentsanti-HLA-DR antibodies, such as hL243, may be of use in combination withtherapeutic radionuclides for sensitization of tumors to radiationtherapy (see, e.g., Allen et al., 2007, Cancer Res. 67:1155).

Therapeutic agents may include a photoactive agent or dye. Fluorescentcompositions, such as fluorochrome, and other chromogens, or dyes, suchas porphyrins sensitive to visible light, have been used to detect andto treat lesions by directing the suitable light to the lesion. Intherapy, this has been termed photoradiation, phototherapy, orphotodynamic therapy. See Joni et al. (eds.), PHOTODYNAMIC THERAPY OFTUMORS AND OTHER DISEASES (Libreria Progetto 1985); van den Bergh, Chem.Britain (1986), 22:430. Moreover, monoclonal antibodies have beencoupled with photoactivated dyes for achieving phototherapy. See Mew etal., J. Immunol. (1983), 130:1473; idem., Cancer Res. (1985), 45:4380;Oseroff et al., Proc. Natl. Acad. Sci. USA (1986), 83:8744; idem.,Photochem. Photobiol. (1987), 46:83; Hasan et al., Prog. Clin. Biol.Res. (1989), 288:471; Tatsuta et al., Lasers Surg. Med. (1989), 9:422;Pelegrin et al., Cancer (1991), 67:2529.

Other useful therapeutic agents may comprise oligonucleotides,especially antisense oligonucleotides that preferably are directedagainst oncogenes and oncogene products, such as bcl-2 or p53. Apreferred form of therapeutic oligonucleotide is siRNA.

Diagnostic Agents

Diagnostic agents are preferably selected from the group consisting of aradionuclide, a radiological contrast agent, a paramagnetic ion, ametal, a fluorescent label, a chemiluminescent label, an ultrasoundcontrast agent and a photoactive agent. Such diagnostic agents are wellknown and any such known diagnostic agent may be used. Non-limitingexamples of diagnostic agents may include a radionuclide such as ¹¹⁰In,¹¹¹In, ¹⁷⁷Lu, ¹⁸F, ⁵²Fe, ⁶²Cu, ⁶⁴Cu, ⁶⁷Cu, ⁶⁷Ga, ⁶⁸Ga, ⁸⁶Y, ⁹⁰Y, ⁸⁹Zr,^(94m)Tc, ⁹⁴Tc, ^(99m)Tc, ¹²⁰I, ¹²³I, ¹²⁴I, ¹²⁵I, ¹³¹I, ¹⁵⁴⁻¹⁵⁸Gd, ³²P,¹¹C, ¹³N, ¹⁵O, ¹⁸⁶Re, ¹⁸⁸Re, ⁵¹Mn, ^(52m)Mn, ⁵⁵Co, ⁷²As, ⁷⁵Br, ⁷⁶Br,^(82m)Rb, ⁸³Sr, or other gamma-, beta-, or positron-emitters.Paramagnetic ions of use may include chromium (III), manganese (II),iron (III), iron (II), cobalt (II), nickel (II), copper (II), neodymium(III), samarium (III), ytterbium (III), gadolinium (III), vanadium (II),terbium (III), dysprosium (III), holmium (III) or erbium (III). Metalcontrast agents may include lanthanum (III), gold (III), lead (II) orbismuth (III). Ultrasound contrast agents may comprise liposomes, suchas gas filled liposomes. Radiopaque diagnostic agents may be selectedfrom compounds, barium compounds, gallium compounds, and thalliumcompounds. A wide variety of fluorescent labels are known in the art,including but not limited to fluorescein isothiocyanate, rhodamine,phycoerytherin, phycocyanin, allophycocyanin, o-phthaldehyde andfluorescamine. Chemiluminescent labels of use may include luminol,isoluminol, an aromatic acridinium ester, an imidazole, an acridiniumsalt or an oxalate ester.

Methods of Therapeutic Treatment

Various embodiments concern methods of treating a cancer in a subject,such as a mammal, including humans, domestic or companion pets, such asdogs and cats, comprising administering to the subject a therapeuticallyeffective amount of an anti-HLA-DR antibody. In preferred embodiments,the anti-HLA-DR antibody is a humanized L243 antibody, as described infurther detail in the Examples below. In more preferred embodiments, theanti-HLA-DR antibody is administered subcutaneously as a highconcentration formulation of between about 100 mg/ml to 225 mg/ml. Useof high concentration formulations allows subcutaneous administration oflow volumes of antibody, preferably between 1 to 3 ml or less.

In certain embodiments, the anti-HLA-DR antibody may be used to treat ahematologic cancer, such as indolent forms of B cell lymphomas,aggressive forms of B cell lymphomas, non-Hodgkin's lymphoma, Hodgkin'slymphoma, chronic lymphocytic leukemia, acute lymphoblastic leukemia,acute myelogenous leukemia, chronic myelogenous leukemia, hairy cellleukemia, Burkitt lymphoma, Waldenstrom's macroglobulinemia, andmultiple myeloma.

In one embodiment, immunological diseases which may be treated with thesubject antibodies may include, for example, joint diseases such asankylosing spondylitis, juvenile rheumatoid arthritis, rheumatoidarthritis; neurological disease such as multiple sclerosis andmyasthenia gravis; pancreatic disease such as diabetes, especiallyjuvenile onset diabetes; gastrointestinal tract disease such as chronicactive hepatitis, celiac disease, ulcerative colitis, Crohn's disease,pernicious anemia; skin diseases such as psoriasis or scleroderma;allergic diseases such as asthma and in transplantation relatedconditions such as graft versus host disease and allograft rejection.

The administration of anti-HLA-DR antibody can be supplemented byadministering concurrently or sequentially a therapeutically effectiveamount of another antibody that binds to or is reactive with anotherantigen on the surface of the target cell. Preferred additional MAbscomprise at least one humanized, chimeric or human MAb selected from thegroup consisting of a MAb reactive with CD4, CD5, CD8, CD14, CD15, CD16,CD19, IGF-1R, CD20, CD21, CD22, CD23, CD25, CD30, CD32b, CD33, CD37,CD38, CD40, CD40L, CD45, CD46, CD52, CD54, CD70, CD74, CD79a, CD80,CD95, CD126, CD133, CD138, CD154, CEACAM5, CEACAM6, B7, AFP, PSMA,EGP-1, EGP-2, carbonic anhydrase IX, PAM4 antigen, MUC1, MUC2, MUC3,MUC4, MUC5, Ia, MIF, HM1.24, HLA-DR, tenascin, Flt-3, VEGFR, P1GF, ILGF,IL-6, IL-25, tenascin, TRAIL-R1, TRAIL-R2, complement factor C5,oncogene product, or a combination thereof. Various antibodies of use,such as anti-CD19, anti-CD20, and anti-CD22 antibodies, are known tothose of skill in the art. See, for example, Ghetie et al., Cancer Res.48:2610 (1988); Hekman et al., Cancer Immunol. Immunother. 32:364(1991); Longo, Curr. Opin. Oncol. 8:353 (1996), U.S. Pat. Nos.5,798,554; 6,187,287; 6,306,393; 6,676,924; 7,109,304; 7,151,164;7,230,084; 7,230,085; 7,238,785; 7,238,786; 7,282,567; 7,300,655;7,312,318; and U.S. Patent Application Publ. Nos. 20080131363;20080089838; 20070172920; 20060193865; 20060210475; 20080138333; and20080146784, each incorporated herein by reference.

The anti-HLA-DR antibody therapy can be further supplemented with theadministration, either concurrently or sequentially, of at least onetherapeutic agent. For example, “CVB” (1.5 g/m² cyclophosphamide,200-400 mg/m² etoposide, and 150-200 mg/m² carmustine) is a regimen usedto treat non-Hodgkin's lymphoma. Patti et al., Eur. J. Haematol. 51: 18(1993). Other suitable combination chemotherapeutic regimens arewell-known to those of skill in the art. See, for example, Freedman etal., “Non-Hodgkin's Lymphomas,” in CANCER MEDICINE, VOLUME 2, 3rdEdition, Holland et al. (eds.), pages 2028-2068 (Lea & Febiger 1993). Asan illustration, first generation chemotherapeutic regimens fortreatment of intermediate-grade non-Hodgkin's lymphoma (NHL) includeC-MOPP (cyclophosphamide, vincristine, procarbazine and prednisone) andCHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone). Auseful second generation chemotherapeutic regimen is m-BACOD(methotrexate, bleomycin, doxorubicin, cyclophosphamide, vincristine,dexamethasone and leucovorin), while a suitable third generation regimenis MACOP-B (methotrexate, doxorubicin, cyclophosphamide, vincristine,prednisone, bleomycin and leucovorin). Additional useful drugs includephenyl butyrate, bendamustine, and bryostatin-1.

The anti-HLA-DR antibody can be formulated according to known methods toprepare pharmaceutically useful compositions, whereby the anti-HLA-DRantibody is combined in a mixture with a pharmaceutically suitableexcipient. Sterile phosphate-buffered saline is one example of apharmaceutically suitable excipient. Other suitable excipients arewell-known to those in the art. See, for example, Ansel et al.,PHARMACEUTICAL DOSAGE FORMS AND DRUG DELIVERY SYSTEMS, 5th Edition (Lea& Febiger 1990), and Gennaro (ed.), REMINGTON'S PHARMACEUTICAL SCIENCES,18th Edition (Mack Publishing Company 1990), and revised editionsthereof.

The anti-HLA-DR antibody can be formulated for intravenousadministration via, for example, bolus injection or continuous infusion.Preferably, anti-HLA-DR antibody is infused over a period of less thanabout 4 hours, and more preferably, over a period of less than about 3hours. For example, the first 25-50 mg could be infused within 30minutes, preferably even 15 min, and the remainder infused over the next2-3 hrs. Formulations for injection can be presented in unit dosageform, e.g., in ampoules or in multi-dose containers, with an addedpreservative. The compositions can take such forms as suspensions,solutions or emulsions in oily or aqueous vehicles, and can containformulatory agents such as suspending, stabilizing and/or dispersingagents. Alternatively, the active ingredient can be in powder form forconstitution with a suitable vehicle, e.g., sterile pyrogen-free water,before use.

Additional pharmaceutical methods may be employed to control theduration of action of the anti-HLA-DR antibody. Control releasepreparations can be prepared through the use of polymers to complex oradsorb the anti-HLA-DR antibody. For example, biocompatible polymersinclude matrices of poly(ethylene-co-vinyl acetate) and matrices of apolyanhydride copolymer of a stearic acid dimer and sebacic acid.Sherwood et al., Bio/Technology 10: 1446 (1992). The rate of releasefrom such a matrix depends upon the molecular weight of the anti-HLA-DRantibody, the amount of anti-HLA-DR antibody within the matrix, and thesize of dispersed particles. Saltzman et al., Biophys. J. 55: 163(1989); Sherwood et al., supra. Other solid dosage forms are describedin Ansel et al., PHARMACEUTICAL DOSAGE FORMS AND DRUG DELIVERY SYSTEMS,5th Edition (Lea & Febiger 1990), and Gennaro (ed.), REMINGTON'SPHARMACEUTICAL SCIENCES, 18th Edition (Mack Publishing Company 1990),and revised editions thereof.

The anti-HLA-DR antibody may also be administered to a mammalsubcutaneously or even by other parenteral routes. Moreover, theadministration may be by continuous infusion or by single or multipleboluses. Preferably, the anti-HLA-DR antibody is administeredsubcutaneously with relatively rapid injection of a small volume ofantibody formulation (see, e.g., U.S. Pat. No. 8,658,773, incorporatedherein by reference).

More generally, the dosage of an administered anti-HLA-DR antibody forhumans will vary depending upon such factors as the patient's age,weight, height, sex, general medical condition and previous medicalhistory. It may be desirable to provide the recipient with a dosage ofanti-HLA-DR antibody that is in the range of from about 1 mg/kg to 25mg/kg as a single intravenous infusion, although a lower or higherdosage also may be administered as circumstances dictate. Morepreferably, the dosage will be 4 to 18 mg/kg, more preferably 6 to 16mg/kg, more preferably 8 to 12 mg/kg. A dosage of 1-20 mg/kg for a 70 kgpatient, for example, is 70-1,400 mg, or 41-824 mg/m² for a 1.7-mpatient. Most preferably, the dose administered to the subject is 200mg. The dosage may be repeated as needed, for example, once per week for4-10 weeks, once per week for 8 weeks, or once per week for 4 weeks. Itmay also be given less frequently, such as every other week for severalmonths, or monthly or quarterly for many months, as needed in amaintenance therapy.

Alternatively, an anti-HLA-DR antibody may be administered as one dosageevery 2 or 3 weeks, repeated for a total of at least 3 dosages. Or, theconstruct may be administered twice per week for 4-6 weeks. If thedosage is lowered to approximately 200-300 mg/m² (340 mg per dosage fora 1.7-m patient, or 4.9 mg/kg for a 70 kg patient), it may beadministered once, twice or even thrice weekly for 3 or more weeks.Alternatively, the dosage schedule may be decreased, namely every 2 or 3weeks for 2-3 months. This is particularly true for maintenance therapy,where lower dosages (e.g. 1, 2, 3, or 4 mg/kg or even lower) may beadministered less frequently, for a prolonged period. It has beendetermined, however, that even higher doses, such as 20 mg/kg onceweekly or once every 2-3 weeks can be administered by slow i.v.infusion, for repeated dosing cycles. The dosing schedule can optionallybe repeated at other intervals and dosage may be given through variousparenteral routes, with appropriate adjustment of the dose and schedule.

In preferred embodiments, the anti-HLA-DR antibodys are of use fortherapy of cancer. Examples of cancers include, but are not limited to,carcinoma, lymphoma, glioblastoma, melanoma, sarcoma, and leukemia,myeloma, or lymphoid malignancies. More particular examples of suchcancers are noted below and include: squamous cell cancer (e.g.,epithelial squamous cell cancer), Ewing sarcoma, Wilms tumor,astrocytomas, lung cancer including small-cell lung cancer, non-smallcell lung cancer, adenocarcinoma of the lung and squamous carcinoma ofthe lung, cancer of the peritoneum, hepatocellular cancer, gastric orstomach cancer including gastrointestinal cancer, pancreatic cancer,glioblastoma multiforme, cervical cancer, ovarian cancer, liver cancer,bladder cancer, hepatoma, hepatocellular carcinoma, neuroendocrinetumors, medullary thyroid cancer, differentiated thyroid carcinoma,breast cancer, ovarian cancer, colon cancer, rectal cancer, endometrialcancer or uterine carcinoma, salivary gland carcinoma, kidney or renalcancer, prostate cancer, vulvar cancer, anal carcinoma, penilecarcinoma, as well as head-and-neck cancer. The term “cancer” includesprimary malignant cells or tumors (e.g., those whose cells have notmigrated to sites in the subject's body other than the site of theoriginal malignancy or tumor) and secondary malignant cells or tumors(e.g., those arising from metastasis, the migration of malignant cellsor tumor cells to secondary sites that are different from the site ofthe original tumor). Cancers conducive to treatment methods of thepresent invention involves cells which express, over-express, orabnormally express HLA-DR.

Other examples of cancers or malignancies include, but are not limitedto: Acute Childhood Lymphoblastic Leukemia, Acute LymphoblasticLeukemia, Acute Lymphocytic Leukemia, Acute Myeloid Leukemia,Adrenocortical Carcinoma, Adult (Primary) Hepatocellular Cancer, Adult(Primary) Liver Cancer, Adult Acute Lymphocytic Leukemia, Adult AcuteMyeloid Leukemia, Adult Hodgkin's Lymphoma, Adult Lymphocytic Leukemia,Adult Non-Hodgkin's Lymphoma, Adult Primary Liver Cancer, Adult SoftTissue Sarcoma, AIDS-Related Lymphoma, AIDS-Related Malignancies, AnalCancer, Astrocytoma, Bile Duct Cancer, Bladder Cancer, Bone Cancer,Brain Stem Glioma, Brain Tumors, Breast Cancer, Cancer of the RenalPelvis and Ureter, Central Nervous System (Primary) Lymphoma, CentralNervous System Lymphoma, Cerebellar Astrocytoma, Cerebral Astrocytoma,Cervical Cancer, Childhood (Primary) Hepatocellular Cancer, Childhood(Primary) Liver Cancer, Childhood Acute Lymphoblastic Leukemia,Childhood Acute Myeloid Leukemia, Childhood Brain Stem Glioma, ChildhoodCerebellar Astrocytoma, Childhood Cerebral Astrocytoma, ChildhoodExtracranial Germ Cell Tumors, Childhood Hodgkin's Disease, ChildhoodHodgkin's Lymphoma, Childhood Hypothalamic and Visual Pathway Glioma,Childhood Lymphoblastic Leukemia, Childhood Medulloblastoma, ChildhoodNon-Hodgkin's Lymphoma, Childhood Pineal and Supratentorial PrimitiveNeuroectodermal Tumors, Childhood Primary Liver Cancer, ChildhoodRhabdomyosarcoma, Childhood Soft Tissue Sarcoma, Childhood VisualPathway and Hypothalamic Glioma, Chronic Lymphocytic Leukemia, ChronicMyelogenous Leukemia, Colon Cancer, Cutaneous T-Cell Lymphoma, EndocrinePancreas Islet Cell Carcinoma, Endometrial Cancer, Ependymoma,Epithelial Cancer, Esophageal Cancer, Ewing's Sarcoma and RelatedTumors, Exocrine Pancreatic Cancer, Extracranial Germ Cell Tumor,Extragonadal Germ Cell Tumor, Extrahepatic Bile Duct Cancer, Eye Cancer,Female Breast Cancer, Gaucher's Disease, Gallbladder Cancer, GastricCancer, Gastrointestinal Carcinoid Tumor, Gastrointestinal Tumors, GermCell Tumors, Gestational Trophoblastic Tumor, Hairy Cell Leukemia, Headand Neck Cancer, Hepatocellular Cancer, Hodgkin's Lymphoma,Hypergammaglobulinemia, Hypopharyngeal Cancer, Intestinal Cancers,Intraocular Melanoma, Islet Cell Carcinoma, Islet Cell PancreaticCancer, Kaposi's Sarcoma, Kidney Cancer, Laryngeal Cancer, Lip and OralCavity Cancer, Liver Cancer, Lung Cancer, Lymphoproliferative Disorders,Macroglobulinemia, Male Breast Cancer, Malignant Mesothelioma, MalignantThymoma, Medulloblastoma, Melanoma, Mesothelioma, Metastatic OccultPrimary Squamous Neck Cancer, Metastatic Primary Squamous Neck Cancer,Metastatic Squamous Neck Cancer, Multiple Myeloma, MultipleMyeloma/Plasma Cell Neoplasm, Myelodysplastic Syndrome, MyelogenousLeukemia, Myeloid Leukemia, Myeloproliferative Disorders, Nasal Cavityand Paranasal Sinus Cancer, Nasopharyngeal Cancer, Neuroblastoma,Non-Hodgkin's Lymphoma, Nonmelanoma Skin Cancer, Non-Small Cell LungCancer, Occult Primary Metastatic Squamous Neck Cancer, OropharyngealCancer, Osteo-/Malignant Fibrous Sarcoma, Osteosarcoma/Malignant FibrousHistiocytoma, Osteosarcoma/Malignant Fibrous Histiocytoma of Bone,Ovarian Epithelial Cancer, Ovarian Germ Cell Tumor, Ovarian LowMalignant Potential Tumor, Pancreatic Cancer, Paraproteinemias,Polycythemia vera, Parathyroid Cancer, Penile Cancer, Pheochromocytoma,Pituitary Tumor, Primary Central Nervous System Lymphoma, Primary LiverCancer, Prostate Cancer, Rectal Cancer, Renal Cell Cancer, Renal Pelvisand Ureter Cancer, Retinoblastoma, Rhabdomyosarcoma, Salivary GlandCancer, Sarcoidosis Sarcomas, Sezary Syndrome, Skin Cancer, Small CellLung Cancer, Small Intestine Cancer, Soft Tissue Sarcoma, Squamous NeckCancer, Stomach Cancer, Supratentorial Primitive Neuroectodermal andPineal Tumors, T-Cell Lymphoma, Testicular Cancer, Thymoma, ThyroidCancer, Transitional Cell Cancer of the Renal Pelvis and Ureter,Transitional Renal Pelvis and Ureter Cancer, Trophoblastic Tumors,Ureter and Renal Pelvis Cell Cancer, Urethral Cancer, Uterine Cancer,Uterine Sarcoma, Vaginal Cancer, Visual Pathway and Hypothalamic Glioma,Vulvar Cancer, Waldenstrom's Macroglobulinemia, Wilms' Tumor, and anyother hyperproliferative disease, besides neoplasia, located in an organsystem listed above.

The methods and compositions described and claimed herein may be used totreat malignant or premalignant conditions and to prevent progression toa neoplastic or malignant state, including but not limited to thosedisorders described above. Such uses are indicated in conditions knownor suspected of preceding progression to neoplasia or cancer, inparticular, where non-neoplastic cell growth consisting of hyperplasia,metaplasia, or most particularly, dysplasia has occurred (for review ofsuch abnormal growth conditions, see Robbins and Angell, BasicPathology, 2d Ed., W. B. Saunders Co., Philadelphia, pp. 68-79 (1976)).

Dysplasia is frequently a forerunner of cancer, and is found mainly inthe epithelia. It is the most disorderly form of non-neoplastic cellgrowth, involving a loss in individual cell uniformity and in thearchitectural orientation of cells. Dysplasia characteristically occurswhere there exists chronic irritation or inflammation. Dysplasticdisorders which can be treated include, but are not limited to,anhidrotic ectodermal dysplasia, anterofacial dysplasia, asphyxiatingthoracic dysplasia, atriodigital dysplasia, bronchopulmonary dysplasia,cerebral dysplasia, cervical dysplasia, chondroectodermal dysplasia,cleidocranial dysplasia, congenital ectodermal dysplasia,craniodiaphysial dysplasia, craniocarpotarsal dysplasia,craniometaphysial dysplasia, dentin dysplasia, diaphysial dysplasia,ectodermal dysplasia, enamel dysplasia, encephalo-ophthalmic dysplasia,dysplasia epiphysialis hemimelia, dysplasia epiphysialis multiplex,dysplasia epiphysialis punctata, epithelial dysplasia,faciodigitogenital dysplasia, familial fibrous dysplasia of jaws,familial white folded dysplasia, fibromuscular dysplasia, fibrousdysplasia of bone, florid osseous dysplasia, hereditary renal-retinaldysplasia, hidrotic ectodermal dysplasia, hypohidrotic ectodermaldysplasia, lymphopenic thymic dysplasia, mammary dysplasia,mandibulofacial dysplasia, metaphysial dysplasia, Mondini dysplasia,monostotic fibrous dysplasia, mucoepithelial dysplasia, multipleepiphysial dysplasia, oculoauriculovertebral dysplasia,oculodentodigital dysplasia, oculovertebral dysplasia, odontogenicdysplasia, opthalmomandibulomelic dysplasia, periapical cementaldysplasia, polyostotic fibrous dysplasia, pseudoachondroplasticspondyloepiphysial dysplasia, retinal dysplasia, septo-optic dysplasia,spondyloepiphysial dysplasia, and ventriculoradial dysplasia.

Additional pre-neoplastic disorders which can be treated include, butare not limited to, benign dysproliferative disorders (e.g., benigntumors, fibrocystic conditions, tissue hypertrophy, intestinal polyps oradenomas, and esophageal dysplasia), leukoplakia, keratoses, Bowen'sdisease, Farmer's Skin, solar cheilitis, and solar keratosis.

In preferred embodiments, the method of the invention is used to inhibitgrowth, progression, and/or metastasis of cancers, in particular thoselisted above.

Additional hyperproliferative diseases, disorders, and/or conditionsinclude, but are not limited to, progression, and/or metastases ofmalignancies and related disorders such as leukemia (including acuteleukemias (e.g., acute lymphocytic leukemia, acute myelocytic leukemia(including myeloblastic, promyelocytic, myelomonocytic, monocytic, anderythroleukemia)) and chronic leukemias (e.g., chronic myelocytic(granulocytic) leukemia and chronic lymphocytic leukemia)), polycythemiavera, lymphomas (e.g., Hodgkin's disease and non-Hodgkin's disease),multiple myeloma, Waldenstrom's macroglobulinemia, heavy chain disease,and solid tumors including, but not limited to, sarcomas and carcinomassuch as fibrosarcoma, myxosarcoma, liposarcoma, chondrosarcoma,osteogenic sarcoma, chordoma, angiosarcoma, endotheliosarcoma,lymphangiosarcoma, lymphangioendotheliosarcoma, synovioma, mesothelioma,Ewing's tumor, leiomyosarcoma, rhabdomyosarcoma, colon carcinoma,pancreatic cancer, breast cancer, ovarian cancer, prostate cancer,squamous cell carcinoma, basal cell carcinoma, adenocarcinoma, sweatgland carcinoma, sebaceous gland carcinoma, papillary carcinoma,papillary adenocarcinomas, cystadenocarcinoma, medullary carcinoma,bronchogenic carcinoma, renal cell carcinoma, hepatoma, bile ductcarcinoma, choriocarcinoma, seminoma, embryonal carcinoma, Wilm's tumor,cervical cancer, testicular tumor, lung carcinoma, small cell lungcarcinoma, bladder carcinoma, epithelial carcinoma, glioma, astrocytoma,medulloblastoma, craniopharyngioma, ependymoma, pinealoma,emangioblastoma, acoustic neuroma, oligodendroglioma, meningioma,melanoma, neuroblastoma, and retinoblastoma.

Expression Vectors

Still other embodiments may concern DNA sequences comprising a nucleicacid encoding an anti-HLA-DR antibody or fusion protein. Fusion proteinsmay comprise an antibody or fragment attached to a different antibody orfragment or to a therapeutic protein or peptide, such as a cytokine.

Various embodiments relate to expression vectors comprising the codingDNA sequences. The vectors may contain sequences encoding the light andheavy chain constant regions and the hinge region of a humanimmunoglobulin to which may be attached chimeric, humanized or humanvariable region sequences. The vectors may additionally containpromoters that express the encoded protein(s) in a selected host cell,enhancers and signal or leader sequences. Vectors that are particularlyuseful are pdHL2 or GS. More preferably, the light and heavy chainconstant regions and hinge region may be from a human EU myelomaimmunoglobulin, where optionally at least one of the amino acid in theallotype positions is changed to that found in a different IgG1allotype, and wherein optionally amino acid 253 of the heavy chain of EUbased on the EU number system may be replaced with alanine. See Edelmanet al., Proc. Natl. Acad. Sci USA 63: 78-85 (1969). In otherembodiments, an IgG1 sequence may be converted to an IgG4 sequence.

The skilled artisan will realize that methods of genetically engineeringexpression constructs and insertion into host cells to expressengineered proteins are well known in the art and a matter of routineexperimentation. Host cells and methods of expression of clonedantibodies or fragments have been described, for example, in U.S. patentapplication Ser. No. 11/187,863, filed Jul. 25, 2005; Ser. No.11/253,666, filed Oct. 20, 2005 and Ser. No. 11/487,215, filed Jul. 14,2006, each incorporated herein by reference in its entirety.

Kits

Various embodiments may concern kits containing components suitable fortreating or diagnosing diseased tissue in a patient. Exemplary kits maycontain at least one or more anti-HLA-DR antibody as described herein.If the composition containing components for administration is notformulated for delivery via the alimentary canal, such as by oraldelivery, a device capable of delivering the kit components through someother route may be included. One type of device, for applications suchas parenteral delivery, is a syringe that is used to inject thecomposition into the body of a subject. Inhalation devices may also beused. In certain embodiments, a therapeutic agent may be provided in theform of a prefilled syringe or autoinjection pen containing a sterile,liquid formulation or lyophilized preparation.

The kit components may be packaged together or separated into two ormore containers. In some embodiments, the containers may be vials thatcontain sterile, lyophilized formulations of a composition that aresuitable for reconstitution. A kit may also contain one or more bufferssuitable for reconstitution and/or dilution of other reagents. Othercontainers that may be used include, but are not limited to, a pouch,tray, box, tube, or the like. Kit components may be packaged andmaintained sterilely within the containers. Another component that canbe included is instructions to a person using a kit for its use.

DOCK AND LOCK® (DNL®) Method

In certain embodiments, the anti-HLA-DR antibodies or fragments may beincorporated into a multimeric complex, for example using a techniquereferred to as DOCK-AND-LOCK® (DNL®). The method exploits specificprotein/protein interactions that occur between the regulatory (R)subunits of cAMP-dependent protein kinase (PKA) and the anchoring domain(AD) of A-kinase anchoring proteins (AKAPs) (Baillie et al., FEBSLetters. 2005; 579: 3264. Wong and Scott, Nat. Rev. Mol. Cell Biol.2004; 5: 959). PKA, which plays a central role in one of the beststudied signal transduction pathways triggered by the binding of thesecond messenger cAMP to the R subunits, was first isolated from rabbitskeletal muscle in 1968 (Walsh et al., J. Biol. Chem. 1968; 243:3763).The structure of the holoenzyme consists of two catalytic subunits heldin an inactive form by the R subunits (Taylor, J. Biol. Chem. 1989;264:8443). Isozymes of PKA are found with two types of R subunits (RIand RH), and each type has α and β isoforms (Scott, Pharmacol. Ther.1991; 50:123). The R subunits have been isolated only as stable dimersand the dimerization domain has been shown to consist of the first 44amino-terminal residues (Newlon et al., Nat. Struct. Biol. 1999; 6:222).Binding of cAMP to the R subunits leads to the release of activecatalytic subunits for a broad spectrum of serine/threonine kinaseactivities, which are oriented toward selected substrates through thecompartmentalization of PKA via its docking with AKAPs (Scott et al., J.Biol. Chem. 1990; 265; 21561)

Since the first AKAP, microtubule-associated protein-2, wascharacterized in 1984 (Lohmann et al., Proc. Natl. Acad. Sci USA. 1984;81:6723), more than 50 AKAPs that localize to various suB cellularsites, including plasma membrane, actin cytoskeleton, nucleus,mitochondria, and endoplasmic reticulum, have been identified withdiverse structures in species ranging from yeast to humans (Wong andScott, Nat. Rev. Mol. Cell Biol. 2004; 5:959). The AD of AKAPs for PKAis an amphipathic helix of 14-18 residues (Carr et al., J. Biol. Chem.1991; 266:14188). The amino acid sequences of the AD are quite variedamong individual AKAPs, with the binding affinities reported for RIIdimers ranging from 2 to 90 nM (Alto et al., Proc. Natl. Acad. Sci. USA.2003; 100:4445). Interestingly, AKAPs will only bind to dimeric Rsubunits. For human RIIα, the AD binds to a hydrophobic surface formedby the 23 amino-terminal residues (Colledge and Scott, Trends Cell Biol.1999; 6:216). Thus, the dimerization domain and AKAP binding domain ofhuman RIIα are both located within the same N-terminal 44 amino acidsequence (Newlon et al., Nat. Struct. Biol. 1999; 6:222; Newlon et al.,EMBO J. 2001; 20:1651), which is termed the DDD herein.

DDD of Human RIIα and AD of AKAPs as Linker Modules

We have developed a platform technology to utilize the DDD of human RIIαand the AD of AKAP proteins as an excellent pair of linker modules fordocking any two entities, referred to hereafter as A and B, into anoncovalent complex, which could be further locked into a stablytethered structure through the introduction of cysteine residues intoboth the DDD and AD at strategic positions to facilitate the formationof disulfide bonds. The general methodology of the “dock-and-lock”approach is as follows. Entity A is constructed by linking a DDDsequence to a precursor of A, resulting in a first component hereafterreferred to as a. Because the DDD sequence would effect the spontaneousformation of a dimer, A would thus be composed of a₂. Entity B isconstructed by linking an AD sequence to a precursor of B, resulting ina second component hereafter referred to as b. The dimeric motif of DDDcontained in a₂ will create a docking site for binding to the ADsequence contained in b, thus facilitating a ready association of a₂ andb to form a binary, trimeric complex composed of a₂b. This binding eventis made irreversible with a subsequent reaction to covalently secure thetwo entities via disulfide bridges, which occurs very efficiently basedon the principle of effective local concentration because the initialbinding interactions should bring the reactive thiol groups placed ontoboth the DDD and AD into proximity (Chimura et al., Proc. Natl. Acad.Sci. USA. 2001; 98:8480) to ligate site-specifically.

In preferred embodiments, the anti-HLA-DR MAb DNL constructs may bebased on a variation of the a₂ b structure, in which an IgGimmunoglobulin molecule (e.g., hL243) is attached at its C-terminal endto two copies of an AD moiety. Preferably the AD moiety is attached tothe C-terminal end of each light chain. Each AD moiety is capable ofbinding to two DDD moieties in the form of a dimer. By attaching acytokine or other therapeutic protein or peptide to each DDD moiety,four copies of cytokine or other therapeutic moiety are conjugated toeach IgG molecule.

By attaching the DDD and AD away from the functional groups of the twoprecursors, such site-specific ligations are also expected to preservethe original activities of the two precursors. This approach is modularin nature and potentially can be applied to link, site-specifically andcovalently, a wide range of substances. The DNL method was disclosed inU.S. Pat. Nos. 7,550,143; 7,521,056; 76,534,866; 7,527,787 and7,666,400, the Examples section of each incorporated herein byreference.

In preferred embodiments, the effector moiety is a protein or peptide,more preferably an antibody, antibody fragment or cytokine, which can belinked to a DDD or AD unit to form a fusion protein or peptide. Avariety of methods are known for making fusion proteins, includingnucleic acid synthesis, hybridization and/or amplification to produce asynthetic double-stranded nucleic acid encoding a fusion protein ofinterest. Such double-stranded nucleic acids may be inserted intoexpression vectors for fusion protein production by standard molecularbiology techniques (see, e.g. Sambrook et al., Molecular Cloning, Alaboratory manual, 2^(nd) Ed, 1989). In such preferred embodiments, theAD and/or DDD moiety may be attached to either the N-terminal orC-terminal end of an effector protein or peptide. However, the skilledartisan will realize that the site of attachment of an AD or DDD moietyto an effector moiety may vary, depending on the chemical nature of theeffector moiety and the part(s) of the effector moiety involved in itsphysiological activity. Site-specific attachment of a variety ofeffector moieties may be performed using techniques known in the art,such as the use of bivalent cross-linking reagents and/or other chemicalconjugation techniques.

DDD and AD Sequence Variants

In certain embodiments, the AD and DDD sequences incorporated into theanti-HLA-DR MAb DNL complex comprise the amino acid sequences of DDD1(SEQ ID NO:1) and AD1 (SEQ ID NO:3) below. In more preferredembodiments, the AD and DDD sequences comprise the amino acid sequencesof DDD2 (SEQ ID NO:2) and AD2 (SEQ ID NO:4), which are designed topromote disulfide bond formation between the DDD and AD moieties.

DDD1 (SEQ ID NO: 1) SHIQIPPGLTELLQGYTVEVLRQQPPDLVEFAVEYFTRLREARA DDD2(SEQ ID NO: 2) CGHIQIPPGLTELLQGYTVEVLRQQPPDLVEFAVEYFTRLREARA AD1(SEQ ID NO: 3) QIEYLAKQIVDNAIQQA AD2 (SEQ ID NO: 4)CGQIEYLAKQIVDNAIQQAGC

However, in alternative embodiments sequence variants AD and/or DDDmoieties may be utilized in construction of the anti-HLA-DR MAb DNLcomplexes. The structure-function relationships of the AD and DDDdomains have been the subject of investigation. (See, e.g., Burns-Hamuroet al., 2005, Protein Sci 14:2982-92; Carr et al., 2001, J Biol Chem276:17332-38; Alto et al., 2003, Proc Natl Acad Sci USA 100:4445-50;Hundsrucker et al., 2006, Biochem J 396:297-306; Stokka et al., 2006,Biochem J 400:493-99; Gold et al., 2006, Mol Cell 24:383-95; Kindermanet al., 2006, Mol Cell 24:397-408, the entire text of each of which isincorporated herein by reference.)

For example, Kinderman et al. (2006) examined the crystal structure ofthe AD-DDD binding interaction and concluded that the human DDD sequencecontained a number of conserved amino acid residues that were importantin either dimer formation or AKAP binding, underlined below in SEQ IDNO:1. (See FIG. 1 of Kinderman et al., 2006, incorporated herein byreference.) The skilled artisan will realize that in designing sequencevariants of the DDD sequence, one would desirably avoid changing any ofthe underlined residues, while conservative amino acid substitutionsmight be made for residues that are less critical for dimerization andAKAP binding. Thus, a potential alternative DDD sequence of use forconstruction of DNL complexes is shown in SEQ ID NO:5, wherein “X”represents a conservative amino acid substitution. Conservative aminoacid substitutions are discussed in more detail below, but could involvefor example substitution of an aspartate residue for a glutamateresidue, or a leucine or valine residue for an isoleucine residue, etc.Such conservative amino acid substitutions are well known in the art.

Human DDD sequence from protein kinase A (SEQ ID NO: 1)SHIQIPPGLTELLQGYTVEVLRQQPPDLVEFAVEYFTRLREARA (SEQ ID NO: 5)XXIXIXXXLXXLLXXYXVXVLXXXXXXLVXFXVXYFXXLXXXXX

Alto et al. (2003) performed a bioinformatic analysis of the AD sequenceof various AKAP proteins to design an RII selective AD sequence calledAKAP-IS (SEQ ID NO:3), with a binding constant for DDD of 0.4 nM. TheAKAP-IS sequence was designed as a peptide antagonist of AKAP binding toPKA. Residues in the AKAP-IS sequence where substitutions tended todecrease binding to DDD are underlined in SEQ ID NO:3. Therefore, theskilled artisan will realize that variants which may function for DNLconstructs are indicated by SEQ ID NO:6, where “X” is a conservativeamino acid substitution.

AKAP-IS sequence (SEQ ID NO: 3) QIEYLAKQIVDNAIQQA (SEQ ID NO: 6)XXXXXAXXIVXXAIXXX

Similarly, Gold (2006) utilized crystallography and peptide screening todevelop a SuperAKAP-IS sequence (SEQ ID NO:7), exhibiting a five orderof magnitude higher selectivity for the RII isoform of PKA compared withthe RI isoform. Underlined residues indicate the positions of amino acidsubstitutions, relative to the AKAP-IS sequence, that increased bindingto the DDD moiety of RIIα. In this sequence, the N-terminal Q residue isnumbered as residue number 4 and the C-terminal A residue is residuenumber 20. Residues where substitutions could be made to affect theaffinity for RIIα were residues 8, 11, 15, 16, 18, 19 and 20 (Gold etal., 2006). It is contemplated that in certain alternative embodiments,the SuperAKAP-IS sequence may be substituted for the AKAP-IS AD moietysequence to prepare anti-HLA-DR MAb DNL constructs. Other alternativesequences that might be substituted for the AKAP-IS AD sequence areshown in SEQ ID NO:8-10. Substitutions relative to the AKAP-IS sequenceare underlined. It is anticipated that, as with the AKAP-IS sequenceshown in SEQ ID NO:3, the AD moiety may also include the additionalN-terminal residues cysteine and glycine and C-terminal residues glycineand cysteine, as shown in SEQ ID NO:4.

SuperAKAP-IS (SEQ ID NO: 7) QIEYVAKQIVDYAIHQA Alternative AKAP sequences(SEQ ID NO: 8) QIEYKAKQIVDHAIHQA (SEQ ID NO: 9) QIEYHAKQIVDHAIHQA(SEQ ID NO: 10) QIEYVAKQIVDHAIHQA

Stokka et al. (2006) also developed peptide competitors of AKAP bindingto PKA, shown in SEQ ID NO:11-13. The peptide antagonists weredesignated as Ht31 (SEQ ID NO:11), RIAD (SEQ ID NO:12) and PV-38 (SEQ IDNO:13). The Ht-31 peptide exhibited a greater affinity for the RHisoform of PKA, while the RIAD and PV-38 showed higher affinity for RI.

Ht31 (SEQ ID NO: 11) DLIEEAASRIVDAVIEQVKAAGAY R1AD (SEQ ID NO: 12)LEQYANQLADQIIKEATE PV-38 (SEQ ID NO: 13) FEELAWKIAKMIWSDVFQQC

Hundsrucker et al. (2006) developed still other peptide competitors forAKAP binding to PKA, with a binding constant as low as 0.4 nM to the DDDof the RII form of PKA. The sequences of various AKAP antagonisticpeptides is provided in Table 1 of Hundsrucker et al. (incorporatedherein by reference). Residues that were highly conserved among the ADdomains of different AKAP proteins are indicated below by underliningwith reference to the AKAP IS sequence (SEQ ID NO:3). The residues arethe same as observed by Alto et al. (2003), with the addition of theC-terminal alanine residue. (See FIG. 4 of Hundsrucker et al. (2006),incorporated herein by reference.) The sequences of peptide antagonistswith particularly high affinities for the RII DDD sequence are shown inSEQ ID NO:14-16.

AKAP-IS (SEQ ID NO: 3) QIEYLAKQIVDNAIQQA AKAP7δ-wt-pep (SEQ ID NO: 14)PEDAELVRLSKRLVENAVLKAVQQY AKAP7δ-L304T-pep (SEQ ID NO: 15)PEDAELVRTSKRLVENAVLKAVQQY AKAP7δ-L308D-pep (SEQ ID NO: 16)PEDAELVRLSKRDVENAVLKAVQQY

Can et al. (2001) examined the degree of sequence homology betweendifferent AKAP-binding DDD sequences from human and non-human proteinsand identified residues in the DDD sequences that appeared to be themost highly conserved among different DDD moieties. These are indicatedbelow by underlining with reference to the human PKA RIIα DDD sequenceof SEQ ID NO:1. Residues that were particularly conserved are furtherindicated by italics. The residues overlap with, but are not identicalto those suggested by Kinderman et al. (2006) to be important forbinding to AKAP proteins. Thus, a potential DDD sequence is indicated inSEQ ID NO:17, wherein “X” represents a conservative amino acidsubstitution.

(SEQ ID NO: 1) SHIQ IP P GL TELLQGYT V EVLR Q QP P DLVEFA VE YF TR L REAR A (SEQ ID NO: 7) XHIX IP X GL XELLQGYT X EVLR X QP X DLVEFA XX YF XX LXEX R X

The skilled artisan will realize that in general, those amino acidresidues that are highly conserved in the DDD and AD sequences fromdifferent proteins are ones that it may be preferred to remain constantin making amino acid substitutions, while residues that are less highlyconserved may be more easily varied to produce sequence variants of theAD and/or DDD sequences described herein.

In addition to sequence variants of the DDD and/or AD moieties, incertain embodiments it may be preferred to introduce sequence variationsin the antibody moiety or the linker peptide sequence joining theantibody with the AD sequence. In one illustrative example, threepossible variants of fusion protein sequences, are shown in SEQ IDNO:18-20.

(L) (SEQ ID NO: 18) QKSLSLSPGLGSGGGGSGGCG (A) (SEQ ID NO: 19)QKSLSLSPGAGSGGGGSGGCG (—) (SEQ ID NO: 20) QKSLSLSPGGSGGGGSGGCG

Amino Acid Substitutions

In certain embodiments, the disclosed methods and compositions mayinvolve production and use of proteins or peptides with one or moresubstituted amino acid residues. As discussed above, methods for makingmonoclonal antibodies against virtually any target antigen are wellknown in the art. Typically, these result in production of murineantibodies against a target antigen. As is well known in the art, theantigen-binding specificity of murine monoclonal antibodies isdetermined largely by the hypervariable complementarity determiningregion (CDR) sequences. Murine antibodies generally comprise 6 CDRsequences, 3 on the antibody light chain and 3 on the heavy chain. Asdescribed in detail above, chimeric, humanized or human versions ofmurine antibodies may be constructed by techniques such as CDR grafting,where the murine CDR sequences are inserted into, for example, humanantibody framework and constant region sequences, or by attaching theentire murine variable region sequences to human antibody constantregion sequences. In alternative embodiments, the variable regionsequences of an antibody may be constructed, for example, by chemicalsynthesis and assembly of oligonucleotides encoding the entire light andheavy chain variable regions of an antibody.

In various embodiments, the structural, physical and/or therapeuticcharacteristics of native, chimeric, humanized or human antibodies, orAD or DDD sequences may be optimized by replacing one or more amino acidresidues. For example, it is well known in the art that the functionalcharacteristics of humanized antibodies may be improved by substitutinga limited number of human framework region (FR) amino acids with thecorresponding FR amino acids of the parent murine antibody. This isparticularly true when the framework region amino acid residues are inclose proximity to the CDR residues.

In other cases, the therapeutic properties of an antibody, such asbinding affinity for the target antigen, the dissociation- or off-rateof the antibody from its target antigen, or even the effectiveness ofinduction of CDC (complement-dependent cytotoxicity) or ADCC (antibodydependent cellular cytotoxicity) by the antibody, may be optimized by alimited number of amino acid substitutions.

In alternative embodiments, the DDD and/or AD sequences used to make theanti-HLA-DR DNL constructs may be further optimized, for example toincrease the DDD-AD binding affinity. Potential sequence variations inDDD or AD sequences are discussed above.

The skilled artisan will be aware that, in general, amino acidsubstitutions typically involve the replacement of an amino acid withanother amino acid of relatively similar properties (i.e., conservativeamino acid substitutions). The properties of the various amino acids andeffect of amino acid substitution on protein structure and function havebeen the subject of extensive study and knowledge in the art.

For example, the hydropathic index of amino acids may be considered(Kyte & Doolittle, 1982, J. Mol. Biol., 157:105-132). The relativehydropathic character of the amino acid contributes to the secondarystructure of the resultant protein, which in turn defines theinteraction of the protein with other molecules. Each amino acid hasbeen assigned a hydropathic index on the basis of its hydrophobicity andcharge characteristics (Kyte & Doolittle, 1982), these are: isoleucine(+4.5); valine (+4.2); leucine (+3.8); phenylalanine (+2.8);cysteine/cystine (+2.5); methionine (+1.9); alanine (+1.8); glycine(−0.4); threonine (−0.7); serine (−0.8); tryptophan (−0.9); tyrosine(−1.3); proline (−1.6); histidine (−3.2); glutamate (−3.5); glutamine(−3.5); aspartate (−3.5); asparagine (−3.5); lysine (−3.9); and arginine(−4.5). In making conservative substitutions, the use of amino acidswhose hydropathic indices are within ±2 is preferred, within ±1 are morepreferred, and within ±0.5 are even more preferred.

Amino acid substitution may also take into account the hydrophilicity ofthe amino acid residue (e.g., U.S. Pat. No. 4,554,101). Hydrophilicityvalues have been assigned to amino acid residues: arginine (+3.0);lysine (+3.0); aspartate (+3.0); glutamate (+3.0); serine (+0.3);asparagine (+0.2); glutamine (+0.2); glycine (0); threonine (−0.4);proline (−0.5+−1); alanine (−0.5); histidine (−0.5); cysteine (−1.0);methionine (−1.3); valine (−1.5); leucine (−1.8); isoleucine (−1.8);tyrosine (−2.3); phenylalanine (−2.5); tryptophan (−3.4). Replacement ofamino acids with others of similar hydrophilicity is preferred.

Other considerations include the size of the amino acid side chain. Forexample, it would generally not be preferred to replace an amino acidwith a compact side chain, such as glycine or serine, with an amino acidwith a bulky side chain, e.g., tryptophan or tyrosine. The effect ofvarious amino acid residues on protein secondary structure is also aconsideration. Through empirical study, the effect of different aminoacid residues on the tendency of protein domains to adopt analpha-helical, beta-sheet or reverse turn secondary structure has beendetermined and is known in the art (see, e.g., Chou & Fasman, 1974,Biochemistry, 13:222-245; 1978, Ann. Rev. Biochem., 47: 251-276; 1979,Biophys. J., 26:367-384).

Based on such considerations and extensive empirical study, tables ofconservative amino acid substitutions have been constructed and areknown in the art. For example: arginine and lysine; glutamate andaspartate; serine and threonine; glutamine and asparagine; and valine,leucine and isoleucine. Alternatively: Ala (A) leu, ile, val; Arg (R)gln, asn, lys; Asn (N) his, asp, lys, arg, gln; Asp (D) asn, glu; Cys(C) ala, ser; Gln (Q) glu, asn; Glu (E) gln, asp; Gly (G) ala; His (H)asn, gln, lys, arg; Ile (I) val, met, ala, phe, leu; Leu (L) val, met,ala, phe, ile; Lys (K) gln, asn, arg; Met (M) phe, ile, leu; Phe (F)leu, val, ile, ala, tyr; Pro (P) ala; Ser (S), thr; Thr (T) ser; Trp (W)phe, tyr; Tyr (Y) trp, phe, thr, ser; Val (V) ile, leu, met, phe, ala.

Other considerations for amino acid substitutions include whether or notthe residue is located in the interior of a protein or is solventexposed. For interior residues, conservative substitutions wouldinclude: Asp and Asn; Ser and Thr; Ser and Ala; Thr and Ala; Ala andGly; Ile and Val; Val and Leu; Leu and Ile; Leu and Met; Phe and Tyr;Tyr and Trp. (See, e.g., PROWL website at rockefeller.edu) For solventexposed residues, conservative substitutions would include: Asp and Asn;Asp and Glu; Glu and Gln; Glu and Ala; Gly and Asn; Ala and Pro; Ala andGly; Ala and Ser; Ala and Lys; Ser and Thr; Lys and Arg; Val and Leu;Leu and Ile; Ile and Val; Phe and Tyr. (Id.) Various matrices have beenconstructed to assist in selection of amino acid substitutions, such asthe PAM250 scoring matrix, Dayhoff matrix, Grantham matrix, McLachlanmatrix, Doolittle matrix, Henikoff matrix, Miyata matrix, Fitch matrix,Jones matrix, Rao matrix, Levin matrix and Risler matrix (Idem.)

In determining amino acid substitutions, one may also consider theexistence of intermolecular or intramolecular bonds, such as formationof ionic bonds (salt bridges) between positively charged residues (e.g.,His, Arg, Lys) and negatively charged residues (e.g., Asp, Glu) ordisulfide bonds between nearby cysteine residues.

Methods of substituting any amino acid for any other amino acid in anencoded protein sequence are well known and a matter of routineexperimentation for the skilled artisan, for example by the technique ofsite-directed mutagenesis or by synthesis and assembly ofoligonucleotides encoding an amino acid substitution and splicing intoan expression vector construct.

EXAMPLES Example 1 Phase I Trial of Subcutaneous hL243 Administration inPatients with B-Cell NHL or CLL

In preclinical studies, a novel anti-HLA-DR IgG4 antibody, hL243(IMMU-114), was consistently more cytotoxic than rituximab (anti-CD20)in the cell lines studied, with minimal CDC and ADCC, but activatinginternal signaling and inducing apoptosis via the AKT survival pathway(Stein et al, 2006, Blood 108:2736-44; Stein et al., 2010, Blood115:5180-90). In vitro studies demonstrated significant growthinhibition of B-cell lymphoma cell lines, including arituximab-resistant cell line. In vivo canine lymphoma safety studieswere performed (Stein et al, 2011, Leuk Lymphoma 52:273-84). A monkeytoxicology study found toxicities with once weekly SQ injections×4 werelimited to mild redness and itching at the injection site.

The present Example represents a Phase I first-in-man study of IMMU-114,to evaluate subcutaneous (SQ) IMMU-114 injection in patients withrecurrent/relapsed B-cell NHL or CLL. Table 2 shows the demographics ofthe treated patient population. Eligible patients had recurrent/relapsedNHL/CLL with at least one prior therapy, ECOG performance status <3,normal baseline renal and liver function, with platelets ≧50,000/mm³ andANC ≧1000/mm³.

TABLE 2 Patient Demographics for Phase I Clinical Trial of SQanti-HLA-DR Male/Female 11/6 Age, median (range) 72 (46-80) ECOG: 0, 1,2 4/9/4 Histology DLBCL 7 FL 5 MZL 2 CLL 2 SLL 1 Prior treatments,median (range) 2 (1-7) Rituximab/anti-CD20 containing 17 Bendamustinecontaining 11 CHOP-based 8 Other* ≦3 *R-CVP (n = 3), RICE (n = 3),Ibrutinib (n = 3), SCT + myeloablative chemotherapy (n = 2), otheragents/regimens (n = 1, each)

Cohorts of 3-6 patients received 200 mg IMMU-114 administered once-,twice-, or thrice-weekly for the first 3 weeks of a 4-week cycle. Allpatients received 2 consecutive treatment cycles, followed 4 weeks laterby elective maintenance therapy (one week of treatment every 4 weeks x4). NCI-CTCAE v. 4.0 was used to grade adverse events (AEs).Dose-limiting toxicity was defined as including: Grade 4 (or Grade 3>7days) hematologic toxicity, excluding lymphopenia; Grade 4 (or Grade 3requiring hospitalization/dialysis) injection reaction, infection ortumor lysis syndrome; Grade 4 fatigue ≧7 days; other Grade 3 or 4toxicity (excluding nausea/vomiting, electrolyte abnormalities w/oclinical sequelae, or liver function abnormality resolved to Grade 1within 3 days of maximal antiemetic/electrolyte replacement therapy); ortoxicity of any Grade causing treatment delays >14 days. Treatmentresponse was assessed 4 weeks after cycle 2, then every 3 months untilprogression, using 2007 IWG-NHL or 2008 IW-CLL criteria.

Results—

Eleven patients (46-80 years old) with 2 median prior treatments (range,1-5; all had received rituximab) have now been treated at dose level(DL) 1 (200 mg weekly, n=3), 2 (400 mg weekly, n=5), and 3 (600 mgweekly, n=3). They had diffuse large B-cell lymphoma (DLBCL, n=5);follicular lymphoma (FL, n=3); CLL (n=1), small lymphocytic lymphoma(SLL, n=1), or marginal zone lymphoma (MZL, n=1). Administrationreactions were limited and all were Grade 1-2 events, predominantlyinjection site erythema. No serious adverse events (SAEs) occurred atDL1 or DL2. At DL3, one DLBCL patient with unrelatedanorexia/hypovolemia withdrew prior to cycle 2 with acute renal failureand fatal gastrointestinal bleeding, and one MZL patient developed fatalseptic shock after completing cycle 2.

Safety laboratories were unremarkable and there has been no evidence ofhuman anti-IMMU-114 antibodies in 5 patients currently evaluated.Circulating leukemic cells in the single CLL patient decreased with eachcycle, but normal B-cell changes in the NHL patients were modest. AtDL1, 2 DLBCL patients progressed after cycle 2, but one FL patientachieved an unconfirmed partial response (PR; 47% tumor shrinkage,progressing 3 months later after completing maintenance treatment). AtDL 2, one DLBCL patient with unrelated pneumonia withdrew after onedose, one DLBCL patient had a PR (60% shrinkage) with a confirmatoryscan pending, one FL patient progressed after cycle 2, one FL patientachieved a PR (83% shrinkage continuing now 10 months later), and oneCLL patient had an unconfirmed PR during cycle 1 (WBC<50% baseline,progressing after 2 months). At DL3, one patient with SLL progressedafter cycle 2 and the other 2 patients with SAEs were not assessed fortreatment response.

A representative example of solid tumor reduction is shown in FIG. 29.Patient 181-001 had extensive abdominopelvic lymphadenopathy, includingtarget lesions shown above (arrows). Comparison of post-treatment CTimages (POST) with baseline CT images (PRE) shows reduction in targetlesions 4 weeks after completing 2 cycles of treatment at dose level 1(200 mg once-weekly).

Antibody serum levels were evaluated on injection days by ELISA. Fordose level 1 (once-weekly), IMMU-114 levels were not detectable (<24ng/ml). For dose levels 2 and 3, IMMU-114 levels on the last week1injection day increased on treatment weeks 1, 2 and 3 of cycles 1 and 2,with peak concentrations of about 40 to 50 ng/ml seen at week 3 withboth dose levels.

Table 3 summarizes the results from five patients with objectiveevidence of treatment activity. Activity was seen in five of tenevaluable patients (50%), including one complete response (10%). Thebest response by subgroup is shown in Table 4.

TABLE 3 Treatment Activity in Evaluable Patients Patient Best ResponseDuration/Outcome 181-001 SD (48% tumor reduction after Progression after(FL, DL1) cycle 2) maintenance (5.3 months from 1^(st) dose) 212-002 CR(initial 83% tumor shrinkage Response ongoing (FL, DL2) after cycle 2;improvement after 1.4 years after 1^(st) dose maintenance with eventualcomplete response) 258-001 PR (60% tumor shrinkage after Currentlyreceiving (DLBCL, cycle 2) maintenance with next DL2) evaluation pending181-005 PR_(BL)* (WBC 87% decreased Progression 4 weeks (CLL, DL2) from102,300 to 12,900 at end after cycle 2 of cycle 2) 181-008 PR_(BL)* (WBC59% decreased Progression 4 weeks (CLL, DL2) from 22,100 to 9,000 at endof after cycle 2 cycle 2) *PRBL = ≧50% decrease in peripheral bloodleukocytosis in CLL patients. Changes in other PR response criteria werenot assessed until after treatment.

TABLE 4 Best Response by Subgroup Response by Best Response SubgroupsPatients CR PR/PR_(BL) SD PD Overall 10 1 3 1 5 Histology DLBCL 4 — 1 —3 FL 3 1 — 1 1 CLL/SLL 3 — 2 — 1 Dose Level DL1: 200 mg once- 3 — — 1 2weekly DL2: 200 mg twice- 6 1 3 — 2 weekly DL3: 200 mg thrice- 1 — — — 1weekly*Results based on 10 patients currently assessable for treatmentresponse. Excludes 2 patients currently being treated (too early forresponse assessment) and 5 patients withdrawn without assessment eitherprior to treatment (neutropenic fever), during treatment cycle 1(pneumonia, disease complication), prior to completing treatment cycle 2(clinical deterioration), or after treatment but prior to first responseassessment 4 weeks later (septic shock).

Conclusion—

SQ injections of IMMU-114 appear to avoid the significant administrationreactions that have limited the development of other anti-HLA-DRantibodies given IV. With lack of toxicity and preliminary efficacyobserved at the two lowest dose levels, DL 2 was selected as forsubsequent expansion cohorts. While IMMU-114 demonstrated activity inthis population relapsed/refractory to rituximab-containing therapies,the presence of short responses in some patients suggests treatmentshould be maintained beyond 2 cycles. Thus, the dosing scheme is beingamended to allow treatment cycles to be repeated until diseaseprogression, to determine an appropriate dosing schedule for undertakinga phase II study. In total, five of ten (50%) of assessable patients(FL×2, CLL×2, DLBCL) had objective evidence of treatment response, withone complete response observed. Circulating leukemic cells in CLLpatients decreased with treatment, while B-cell changes in NHL patientswere modest. The excellent safety profile and apparent therapeuticeffect of IMMU-114 supports its use in hematologic cancers of humanpatients.

Example 2 Construction of a Humanized L243 Antibody

Molecular Cloning of L243V_(K) and V_(H) Genes

The hybridoma cell clone producing the mAb mL243 (ATCC HB55) wascultured in HSFM medium (Life Technologies, Inc) supplemented with 10%FBS (Hyclone). The genes encoding the VK (VK1BACK/CK3′) and VH(VH1BACK/VH1FOR) of mL243 were cloned by RT-PCR and the sequences weredetermined by DNA sequencing. Multiple independent clones were sequencedto eliminate possible errors resulting from the PCR reaction.

Sequence Design of hL243 V Genes

Searching the human V_(K) and V_(H) sequences in the Kabat database, theFRs of mL243 V_(K) and V_(H) were found to exhibit the highest degree ofsequence homology to human REI V_(K) and RF-TS3 V_(H), respectively. Oneexception is the FR4 of mL243 V_(H), which showed the highest sequencehomology with that of NEWM V_(H). Therefore, the human REI frameworksequences were used as the scaffold for grafting the CDRs of mL243VK,and a combination of RF-TS3 and NEWM framework sequences were used forhL243 V_(H). There are a number of amino acid changes in each chainoutside of the CDR regions when compared to the starting human antibodyframeworks. Several amino acid residues in murine FRs that flank theputative CDRs were maintained in the reshaped hL243 Fv based on theguideline previously established (Qu et al, Clin Cancer Res (1999) 53095s-3100s). These residues are R37, K39, V48, F49, and G100 ofmL243V_(k) and F27, K38, K46, A68, and F91 of mL243V_(H) (FIG. 3 andFIG. 4 respectively). Also see SEQ ID NO:3 and SEQ ID NO:4 respectivelyfor the sequences of hL243 V_(L) and hL243 V_(H) respectively.

Construction of hL243 V Sequences

A modified strategy as described by Leung et al. (Mol Immunol (1995)32:1413-1427) was used to construct the designed V_(K) and V_(H) genesfor hL243, using a combination of long oligonucleotide syntheses andPCR. For the construction of the hL243 V_(H) domain, two longoligonucleotides, hL243VHA (175-mer) and hL243VHB (168-mer) weresynthesized on an automated DNA synthesizer (Applied Biosystem).

hL243VHA represents nt 23 to 197 of the HL243VH domain (SEQ ID NO: 21)GGTCTGAGTTGAAGAAGCCTGGGGCCTCAGTGAAGGTTTCCTGCAAGGCTTCTGGATTTACCTTCACAAACTATGGAATGAACTGGGTGAAGCAGGCCCCTGGACAAGGGCTTAAGTGGATGGGCTGGATAAACACCTACACTAGAGAGCCAACATATGCTGATGACTTCAAGGG hL243VHB represents the minus strand of thehL243VH domain complementary to nt 176 to 343. (SEQ ID NO: 22)ACCCTTGGCCCCAGTAGTCAAAACCCGTAGGTACAACCGCAGTAATATCTCTTGCACAGAAATACACGGCAGTGTCGTCAGCCTTTAGGCTGCTGATCTGGAGATATGCCGTGCTGACAGAGGTGTCCAAGGAGAAGGCAAACCGTCCCT TGAAGTCATC AGCATATG

The 3′-terminal sequences (22 nt residues) of hL243VHA and B arecomplementary to each other, as underlined in the above sequences. The3′-ends of hL243VHA and B anneal to form a short double stranded DNAflanked by the rest of the long oligonucleotides. Each annealed endserves as a primer for the replication of the single stranded DNA in aPCR reaction, resulting in a double strand DNA composed of the nt 23 to343 of hL243VH. This DNA was further amplified in the presence of ashort oligonucleotide primer pair, hRS7VHBACK and hL243VHFOR, to formthe full-length hL243VH. Because of the sequence identity between hRS7VHand hL243VH in this region, hRS7VHBACK, previously designed and used forhRS7 Ab, was used here.

hRS7VHBACK (SEQ ID NO: 23) GTGGTGCTGCAGCAATCTGGGTCTGAGTTGAAGAAGCChL243VHFOR (SEQ ID NO: 24) TGAGGAGACGGTGACCAGGGACCCTTGGCCCCAGTAGT

A minimum amount of hL243VHA and B (determined empirically) wasamplified in the presence of 10 μl of 10×PCR Buffer (500 mM KCl, 100 mMTrisHCL buffer, pH 8.3, 15 mM MgCl₂), 2 μmol of hRS7VHBACK andhL243VHFOR, and 2.5 units of Taq DNA polymerase (Perkin Elmer Cetus,Norwalk, Conn.). This reaction mixture was subjected to 3 cycle of PCRreaction consisting of denaturation at 94° C. for 1 minute, annealing at45° C. for 1 minute, and polymerization at 72° C. for 15 minutes, andfollowed by 27 cycles of PCR reaction consisting of denaturation at 94°C. for 1 minute, annealing at 55° C. for 1 minute, and polymerization at72° C. for 1 minute. Double-stranded PCR-amplified product for hL243VHwas gel-purified, restriction-digested with PstI and BstEII and clonedinto the complementary Pstl/BstEII sites of the heavy chain stagingvector, VHpBS4.

For constructing the full length DNA of the humanized V_(K) sequence,hL243 VKA (155-mer) and hL243VKB (155-mer) were synthesized as describedabove. hL243VKA and B were amplified by two short oligonucleotideshlmmu31VKBACK and hlmmu31VKFOR as described above. hImmuS 1 VKB ACK andhlmmuS1 VKFOR were designed and used previously for a humanized anti-AFPAb (Qu et al, Clin Cancer Res (1999) 5 395-31).

hL243VKA represents nt 21 to 175 of the hL243VD domain (SEQ ID NO: 25)TCCATCATCTCTGAGCGCATCTGTTGGAGATAGGGTCACTATCACTTGTCGAGCAAGTGAGAATATTTACAGTAATTTAGCATGGTATCGTCAGAAACCAGGGAAAGCACCTAAACTGCTGGTCTTTGCTGCATCAAACTTAGCAGATGG TGTGChL243VKB represents the minus strand of thehL243VK domain complementary to nt 154 to 312 (SEQ ID NO: 26)CAGCTTGGTCCCTCCACCGAACGCCCACGGAGTAGTCCAAAAATGTTGACAATAATATGTTGCAATGTCTTCTGGTTGAAGAGAGCTGATGGTGAAAGTATAATCTGTCCCAGATCCGCTGCCAGAGAATCGCGAAGGCACACCATCTGC TAAGTTTGAhImmu31VKBACK (SEQ ID NO: 27) GACATTCAGCTGACCCAGTCTCCATCATCTCTGAGCGChImmu31VKFOR (SEQ ID NO: 28) CCGGCAGATCTGCAGCTTGGTCCCTCCACCG

Gel-purified PCR products for hL243VK were restriction-digested withPvuII and BglHI and cloned into the complementary PvuI/BclI sites of thelight chain staging vector, VKpBR2. The final expression vectorhL243pdHL2 was constructed by sequentially subcloning the Xbal-BamHI andXhoI/NotI fragments of hL243V_(K) and V_(H), respectively, into pdHL2 asdescribed above.

Construction of the Expression Vectors for hL243 Antibodies

A final expression vector hL243pdHL2 was constructed by sequentiallysubcloning the Xbal-BamHI and XhoI/NotI fragments of hL243V_(K) andV_(H), respectively, into pdHL2 as described previously (Losman et alCancer, 80:266, 1997). The expression vector pdHL2, as described byGilles et al (J Immunol Methods 125:191, 1989), contains the genomicsequence of the human γ1 chain, therefore, the hL243 is an IgG1/Kisotype.

To construct the expression vector for hL243 of other isotypes, such asIgG4/K, the genomic sequence of human γ1 chain was replaced with that ofγ4 chain, which was obtained by PCR amplification. The template used wasthe genomic DNA extracted from ATCC CRL-11397 cell and the primer pairwas P-SacII CCGCGGTCACATGGCACCACCTCTCTTGCAGCTTCCACCAAGGGCCC (SEQ IDNO:29) and P-EagI CCGGCCGTCGCACTCATTTACCCAGAGACAGGG (SEQ ID NO:30). Theamplified PCR product was cloned into TOPO-TA sequencing vector(Invitrogen) and the sequence was confirmed by DNA sequencing.

A point mutation, Ser241Pro (based on Kabat numbering) was introducedinto the hinge region of the γ4 sequence to avoid formation ofhalf-molecules when the IgG4 Ab is expressed in mammalian cell cultures(Schuurman et al, Mol Immunol 38:1, 2001). The human γ4 hinge regionsequence between PstI and StuI restriction sites (56 bp) was replacedwith a synthetic DNA fragment with substitution of the TCA codon forSer241 to CCG for Pro. The human γ1 genomic sequence in hL243pdHL2 wassubstituted with the mutated γ4 sequence, resulting in the finalexpression vector, designated as hL243γ4PpdHL2, for the IgG4 isotypehL243.

Transfection and Expression of hL243 Antibodies

Approximately 30 μg of the expression vector for hL243 or hL243γ4P waslinearized by digestion with SalI and transfected into Sp2/0-Ag14 cellsby electroporation (450V and 25 g). The transfected cells were platedinto 96-well plates for 2 days and then selected for drug-resistance byadding MTX into the medium at a final concentration of 25 pM.MTX-resistant colonies emerged in the wells after 2-3 weeks.Supernatants from colonies surviving selection were screened for humanAb secretion by ELISA assay. Briefly, 100 ul supernatants were addedinto the wells of a microtiter plate precoated with GAH-IgG, F(ab′)₂fragment-specific Ab and incubated for 1 h at room temperature. Unboundproteins were removed by washing three times with wash buffer (PBScontaining 5% polysorbate 2). HRP-conjugated GAH-IgG, Fcfragment-specific Ab was added to the wells. Following an incubation of1 h, the plate was washed. The bound HRP-conjugated Ab was revealed byreading A₄₉₀ nm after the addition of a substrate solution containing 4mM OPD and 0.04% H₂O₂. Positive cell clones were expanded and hL243 andhL243γ4P were purified from cell culture supernatant by affinitychromatography on a Protein A column.

The Ag-Binding Specificity of hL243

Ag-binding activity and specificity of HL243 was shown by a cell surfacebinding assay. Raji cells were incubated in PBS/BSA (1%) containingsaturate concentration of purified hL243 (2 μg/ml) for 1 h at 4° C.After washing, cell surface-bound hL243 was detected by incubating theRaji cells in the buffer containing a PE-conjugated 2^(nd) antibody(goat anti-human IgG, Fc fragment specific) and counting in a Guave PCAsystem (Guava Technologies, Inc, Hayword, Calif.). As shown in FIG. 5,hL243 bound to an antigen on Raji cells recognized by mL243 because thebinding is specifically blocked by preincubation of the cells withmL243, indicating the Ag-binding specificity of mL243 is preserved inthe humanized version.

The Ag-Binding Activity of hL243γ4P

A competition cell-binding assay was carried out to assess theimmunoreactivity of hL243γ4P relative to the parent mL243. A constantamount of ¹²⁵I-labeled murine L243 or hL243γ4P (100,000 cpm, ˜10 μCi/μg)was incubated with human lymphoma cells (Raji, Daudi or Ramos) in thepresence of varying concentrations (0.2-700 nM) of purified hL243γ4P ormurine L243 at 4° C. for 1-2 h. Unbound Abs were removed by washing thecells in PBS. The radioactivity associated with cells was determinedafter washing. As shown in FIG. 6, murine L243 and hL243γ4P mAbscompeted with each other for the binding to the cell surface antigen,indicating they recognize same antigenic determinant. hL243γ4P showed anapparent ˜2-fold stronger binding avidity than mL243 because it competedbetter than mL243 (EC₅₀ of ˜7 vs ˜16.5 nM).

The antigen-binding affinity constant of hL243γ4P was determined bydirect cell surface binding assay of the radiolabeled antibodies andScatchard plot analysis. To measure specific cell surface antigenbinding, two sets of cells were prepared and used in the binding assayto estimate the non-specific and total binding of radioactivities,respectively. The cells for non-specific binding were pre-incubated withexcess amount of unlabled Ab to block all surface antigen sites prior toadding the radiolabeled antibody, while those for total binding werepre-incubated in PBS. After pre-incubation, varying amounts of either¹²⁵I-hL243γ4P or ¹²⁵I-mL243 were added and incubated with 2×10⁵ humanlymphoma cells (Raji, Daudi or Ramos) at 4° C. for 2 h and unboundantibodies were removed by washing. The cell-associated radioactivitywas counted. The specific cell surface binding of the radiolabeledantibody at a given concentration of radiolabeled antibody wascalculated as: the counts of total binding minus the counts ofnon-specific binding. Scatchard plot analysis was then performed todetermine the maximum number of hL243γ4P and mL243 binding sites percell and the apparent dissociation constants of the equilibrium binding.As shown in FIG. 7, the maximum binding of hL243γ4P and mL243 to Daudicells was virtually same, ˜6×10⁵ molecules/cell, indicating they boundto the same Ag. The apparent dissociation constant values for hL243γ4Pand mL243 were calculated to be 2.6 and 14 nM, respectively. Similarresults were obtained with Raji and Ramos cells (data not shown).

Example 3 hL243γ4P Functional Studies

In vitro cell-based studies were conducted to determine whether hL243γ4Phad retained its antiproliferative effect and whether effector cell andcomplement binding functions have been abrogated. This study indicatedthat the antiproliferative effect had been maintained, while effectorcell and complement binding functions had been abrogated.

Effector Cell Assay

The goal of replacing the Fc region of hL243 with an IgG4 isotype Fcregion was to abrogate effector cell functions through Fcγ-receptor.Complement-binding CDC and ADCC assays were performed to assess thesefunctions by hL243γ4P.

CDC

Daudi cells were incubated with serial dilutions of the antibodieshL243, hL243γ4P, hA20 (as another positive control) and hMN14 (negativecontrol) in the presence of human complement for 2 h. This was followedby the addition of resazurin to assess cell viability. Both untreatedand maximum lysis controls were included. Fluorescence readings wereobtained 5 hours after resazurin addition. The fluorescence levelobtained is directly correlated to the amount of viable cells. Percentviable cells was calculated by the formula (Test-maximumlysis)/(untreated control−maximum lysis)×100. The results indicated thathL243γ4P does not produce any complement-mediated cytotoxic effect oncells compared to hL243 (EC₅=2.6 nM) and hA2 (EC₅=0.66 nM). See FIG. 8and FIG. 15.

ADCC

Daudi cells were incubated with hA20, hL243, hL243γ4P and hMN-14 at 5μg/ml. Effector cells were added at a ratio of 5:1. After 4 hours celllysis was assayed by LDH release (FIG. 9A) and cell lysis (FIG. 9B).

In these results where the effects of antibody alone on effector cellsare shown it can be seen that the hL243 induced significant lysis ofeffector cells while hL243γ4P did not. When the specific lysis figuresare corrected for the effect on effector cells, hL243γ4P shows muchreduced lysis of target cells compared to hL243 (12% vs 48%).

In Vitro Proliferation Assays

A multiplex colorimetric assays utilizing both MTS bioreduction (fordetermination of the number of viable cells) and BrdU (forquantification of cell proliferation based on the measurement of BrdUincorporation during DNA synthesis) were performed. Daudi and Raji cellswere incubated with serial dilutions of hL243γ4P for 2 and 3 days. mL243and hMN-14 were used as positive and negative controls respectively.After incubation, BrdU and MTS assays were performed. Results of the MTSassays are shown in FIG. 10 and FIG. 11. BRDU assays gave similarresults (not shown). These results indicate hL243γ4P inhibitsproliferation of Raji and Daudi cell lines. However in similarexperiments in the EBV negative cell line Ramos, inhibition ofproliferation was only observed in the presence of a crosslinking antiFc (Fab)₂.

Example 4 Comparison of In Vivo Efficacy of hL243γ4P and mL243 (IgG2a)in a Xenograft Model of Human Non-Hodgkin's Lymphoma

A therapeutic study was performed to compare the in vivo efficacy ofhumanized L243-IgG4 and murine L243-IgG2a monoclonal antibody isotypes,in a xenograft model of human non-Hodgkin's lymphoma (Raji). Prior invitro studies have shown that replacing the Fc region of L243-IgG1 withan IgG4 isotype abrogates the effector cell functions of the antibody(ADCC and CDC), while retaining the antiproliferative effects. Priorstudies using fully human anti-HLA-DR antibodies engineered as an IgG4isotype have also been shown to minimize side effects due toFcγ-mediated effector functions while providing excellent tumoricidalactivity in vitro, and in vivo in xenograft models of non-Hodgkinslymphoma and animal models (cynomologus monkeys) with no long-lastinghematological effects. See Nagy et al, Nature Medicine, 8:801 (2002).Thus, this study aimed to determine if hL243-IgG4 could maintainsignificant antitumor efficacy in a xenograft model. In the absence ofsufficient quantity of hL243-IgG1, mL243 IgG2a was used (murine IgG2a isthe equivalent of human IgG1 in complement fixation, and effectingADCC).

SCID mice were injected with 2.5 million Raji cells. Therapy withhL243-IgG4 or mL243-IgG2a was initiated 1 day post tumor celladministration. Both groups of mice injected with saline or withnon-specific control antibody, hMN-14, had a median survival time (MST)of 17 days. All the groups of mice treated with either humanized ormurine L243 had significantly improved life span compared to miceinjected with saline or hMN-14 (P<0.0001). Treatment with various dosesof hL243 IgG4 resulted in a dose-response relationship, with micereceiving higher doses having better survival times. In the group ofanimals treated with various doses of mL243 IgG2a, the cure rate was inthe range of 80-100%. See FIG. 12.

This study showed the concurrent retention of antitumor efficacy andremoval of complement binding activity of the IgG4 construct of L243.Significant therapeutic benefits using the aforementioned constructs maybe achieved in patients for the treatment of autoimmune diseases,lymphomas, and leukemias, as well as immune dysregulatory, metabolic,and neurodegenerative diseases involving HLA-DR expression.

Example 5 In Vitro Comparison of hL243 with L243 and Anti-B Cell MAbs inthe Treatment of Human and Canine Lymphomas

A 0.5 mg sample of hL243 (IgG4 isotype) was tested for reactivity withlymphoma cell lines and a dog B cell lymphoma aspirate in comparison tothe murine L243 as well as in comparison to other anti-B cell MAbs. Twofunctional studies were also done. The ability of the hL243 to induceapoptosis in the dog lymphoma aspirate was determined, and theanti-proliferative activity of the hL243 was tested against Namalwa, ahuman lymphoma cell line reported to be resistant to rituximab.

The binding of humanized or chimeric MAbs on human B cell lymphomas weremeasured by flow cytometry using a Fluorescence-Activated Cell Sorter(FACS) in which the following MAbs—hMN-14, hLL1, hLL2, hA20, RITUXAN®,and hL243 were stained with FITC goat anti-human(GAH) IgG Fc. The celllines chosen were Namalwa (a rituximab resistant human B cell lymphomacell line), SU-DHL-6 (a human B cell non-Hodgkin's lymphoma), WSU-FSCCL(an EBV-negative low-grade human B cell lymphoma cell line), Raji,Daudi, and Ramos cells. As shown in Table 6, hL243 bound to all theaforementioned cell lines. In particular, hL243 bound to the Namalwacells that are CD20-unresponsive, showing greater binding than otherhumanized MAbs. (See Table 5) Furthermore, hL243 demonstratedanti-proliferative activity in the rituximab resistant human B celllymphoma cell line, Namalwa, as measured by a ³H-thymidine uptake assay.The other anti-CD20 antibody, humanized A20 (hA20), developed byImmunomedics, Inc, showed similar results to rituximab, a chimericanti-CD20 known as RITUXAN®. See Stein et al. (2004) Clin Cancer Res 10:2868-2878.

TABLE 5 Comparison of binding of humanized and murine MAbs on NamalwaGEO MEAN GEO MEAN Fluorescence Fluorescence Humanized 2nd Ab:FITC Murine2nd Ab: FITC MAbs GAH MAbs GAM none 2.52 none 2.91 HMN14 2.49 Ag8 3.64hRS7 2.47 MN14 3.32 hLL1 10.06 RS7 3.39 hLL2 6.76 LL1 17.31 hA20 6.28LL2 10.46 Rituximab 7.33 1F5 3.83 HL243 324.16 m2B8 6.16 L243 594.96

As shown in FIG. 14A-B, the hL243 MAb yielded 28% inhibition ofproliferation when given alone. This was increased to 51% when hL243 wasgiven in combination with anti-human IgG second antibody. When used incombination with rituximab the activity was increased to a level greaterthan that of either MAb alone. See FIG. 14-B. Thus, anti-HLA-DRantibodies used in combination with other anti-TAA antibodies mayexhibit synergistic effects against lymphoma and other diseases.

TABLE 6 Phenotyping cell lines (Binding of humanized or chimeric MAbs onB cell lines by FACS Assay) Indirect assay using FITC-GAH Fc 2nd Abstaining Geometric Mean Fluorescence None hMN14 hLLl hA20 RituximabhL243 Namalwa 2.5 2.36 7.81 6.4 10.11 14.12 260.8 SU-DHL-6 4.6 4.9417.29 11 1199.34 1308.89 572.2 WSU-FSCCL 2.6 2.66 8.66 4.1 8.91 12.45466.7 Raji 6.8 6.96 95.1 22.

267.09 394.57 971.9 Daudi 3.1 3.16 48.77 51.

240.96 380.45 937.4 Ramos 3.1 3.13 23.25 14.

203.65 374.98 277.5

indicates data missing or illegible when filed

The studies also demonstrated that hL243 has a greater binding affinityto the dog lymphoma cells than other humanized MAbs. See Table 7. Inaddition, hL243 was able to induce apoptosis in the dog lymphoma cellswhen crosslinked with an anti-human IgG second antibody, measured as %cells with a sub GO/G1 phase DNA content (see FIG. 13).

TABLE 7 Phenotyping dog lymphoma aspirate Murine Humanized MAbs %Positive Mean FL MAbs % Positive Mean FL none 3.85 3.37 none 4.48 3.24Ag8 2.81 3.04 hMN-14 4.63 3.24 L243 77.77 10.41 hL243 26.33 5.47 m2B82.61 3.11 hA2 3.96 3.25 LL1 6.69 4.01 hLL1 4.71 3.33 LL2 5.05 3.73 hLL24.85 3.37

Example 6 hL243 Antibody Combinations and their Effects

Methods

Antibodies

The hybridoma cell clone producing the anti-HLA-DR monoclonal antibody,mL243, was obtained from ATCC (ATCC number HB-55). Cells were culturedin HSFM medium (Life Technologies, Inc) supplemented with 10% FBS(Hyclone). The genes encoding the Vκ and V_(H) genes of L243 were clonedby RT-PCR. The humanized L243 isotype), hL243γ1, was generatedsimilarly, as described previously (Leung et al., Hybridoma 13:469(1994); Leung et al., Mol Immunol 32:1413 (1995); Stein et al., Blood14:375 (2004); Govindan et al., Breast Cancer Res Treat 84:173 (2004)).

The IgG4/κ isotype of hL243, hL243γ4p, can be constructed by replacingthe heavy chain constant region coding sequence for the human γ1 chainwith that of γ4 chain. A point mutation, Ser241Pro (based on Kabatnumbering) was introduced into the hinge region of the γ4 sequence inorder to avoid formation of half-molecules when the antibody isexpressed and produced in mammalian cell cultures (Schuurman et al., MolImmunol 38:1 (2001)). Other MAbs used in the studies were rituximab,purchased from IDEC Pharmaceuticals Corp. (San Diego, Calif.), andhMN-14, or labetuzumab (humanized anti-carcinoembryonic antigen IgG1),provided by Immunomedics, Inc. The construction and characterization ofhMN-14, used here as a negative isotype control, have been describedpreviously (see, e.g., U.S. Pat. No. 5,874,540).

Cells

Exemplary cell lines were used in several studies. For example, theBurkitt lymphoma lines, Daudi, Raji, and Ramos, were purchased from theAmerican Type Culture Collection (Manassas, Va.). Non-Burkitt lymphomacell lines were obtained as follows: RL and SU-DHL-6, which contain thechromosomal translocation t(14; 18), were obtained from Dr John Gribben(Dana-Farber Cancer Institute, Boston, Mass.) and Dr Alan Epstein(University of Southern California, Los Angeles, Calif.), respectively.Cell lines SU-DHL-4, SU-DHL-1, and Karpas 422 were provided by Dr MyronCzuczman (Roswell Park Cancer Institute, Buffalo, N.Y.), and WSU-FCCLand DoHH2 cell lines were obtained from Dr Mitchell Smith (Fox ChaseCancer Center, Philadelphia, Pa.). The cells were grown as suspensioncultures in DMEM (Life Technologies, Gaithersburg, Md.), supplementedwith lo % fetal bovine serum, penicillin (100 U/ml), streptomycin (100μg/ml), and L-glutamine (2 mM) (complete media).

Flow Cytometric Assays

Immunophenotyping.

Indirect immunofluorescence assays were performed with the panel of celllines described above, using FITC-goat anti-human IgG (Tago, Inc.,Burlingame, Calif.) essentially as described previously, and analyzed byflow cytometry using a FACSCaliber (Becton Dickinson, San Jose, Calif.).

Analysis of Apoptosis.

Flow cytometric analysis of cellular DNA was performed followingpropidium iodide staining. Cells were placed in 24-well plates (5×10⁵cells/well) and subsequently treated with MAbs (5 μg/ml). Three wellswere prepared with each MAb to study the effects of crosslinking withgoat anti-mouse or goat anti-human second antibodies. Following a 2-minincubation with the primary MAbs (37° C., 5% CO₂), F(ab′)₂ goatanti-mouse IgG Fcγ-specific second antibody (Jackson Laboratories, WestGrove, Pa.) was added to one well from each primary MAb to adjust thesecond antibody concentration to 20 pg/ml. F(ab′)₂ goat anti-human IgGFcγ-specific (Jackson Laboratories) was similarly added to the secondwell from each primary MAb, and the volume of the third set wasequalized by addition of medium. Following a 48-h incubation (37° C., 5%CO₂), cells were transferred to test tubes, washed with PBS, and thenresuspended in hypotonic propidium iodide solution (50 mg/ml propidiumiodide in 0.1% sodium citrate, 0.1% Triton X-100). Samples were analyzedby flow cytometry using a FACSCaliber. Percent apoptotic cells wasdefined as the percent of cells with DNA staining before G0/G1 peak(hypodiploid).

Antigen Expression of Cultured Lymphoma Cells

Flow cytometry analysis was performed using indirect immunofluorescentstaining to show that hL243γ4P binds to a panel of cultured human B celllymphomas. A comparison to other surface antigens is shown. As seen inTable 8, the hL243γ4P MAb binds to all the tested cell lines. A strongerexpression was observed on Daudi and Raji, but the level of fluorescencestaining is strong on all the cell lines tested. Binding was compared tothat of humanized MAbs against other B cell antigens (CD74, CD22, CD20),the murine-human chimeric anti-CD20 MAb rituximab, and a humanizedanti-CEA MAb (negative control). The staining with hL243γ4P was markedlygreater than that of CD22 and CD74 on all seven cell lines. CD20staining was more variable, as shown by reactivity with the humanized(hA20) and chimeric (rituximab) MAbs. The Burkitt's lines, Daudi, Raji,and Ramos, expressed intermediate levels of CD20, whereas the follicularand diffuse large B cell lymphoma lines assessed varied. In comparisonto HLA-DR expression measured by hL243γ4P binding, SU-DHL-6 has higherCD20 expression, Namalwa, and WSU-FSCCL lower CD20 expression, and RLapproximately equal expression of both antigens.

Effector Cell Assays

Induction of ADCC was measured in Raji, Daudi, and SU-DHL-6 by calceinAM release. The activity of hL243γ4P was compared to that of the murineL243 and rituximab, as a positive control. As expected, rituximab andthe murine L243 induced significantly more cell lysis than the negativecontrols (no MAb and murine and humanized MN-14) and hL243γ4P did not(FIG. 16).

TABLE 8 Binding of humanized or chimeric MAbs on B cell lines Anindirect flow cytometry assay was performed using FITC-GAH Fc specific2nd antibody staining Geometric Mean Fluorescence anti- anti- anti-anti- anti- anti- CEA CD74 CD22 CD20 CD20 HLA-DR none (hMN14) (hLL1)(hLL2) (hA20) (Rituximab) (hL243γ4P) Daudi 3.2 3.2 48.8 517 241.0 380.5937.4 Namalwa 2.6 2.4 7.8 64 10.1 14.1 260.9 Raji 6.9 7.0 95.1 226 267.1394.6 972.0 Ramos 3.1 3.1 23.3 146 203.7 375.0 277.6 RL 2.4 2.8 7.9 51127.5 147.8 112.2 SU-DHL-6 4.6 4.9 17.3 11 1199.3 1308.9 572.3 WSU-FSCCL2.7 2.7 8.7 42 8.9 12.5 466.8

In Vitro Anti Proliferative Effects

The effect of hL243 on cellular proliferation was assessed using the³H-thymidine uptake assay on Raji, FSCCL, and Namalwa cells (FIG. 17Band Table 9). The effect of hL243γ4P was compared to that of rituximaband to rituximab combined with hL243γ4P, in the presence or absence of acrosslinking anti Fc antibody. In FSCCL, previously shown to berelatively insensitive to rituximab, hL243γ4P yielded significantlygreater inhibition of proliferation than rituximab. In Ramos, hL243 andrituximab activity were similar, and the combination was more effectivethan either alone. The combination may have a synergistic effect.Cross-linking with an anti-human Fc antibody was required forsignificant anti-proliferative activity to be seen in Ramos. In Namalwa,as with FSCCL, hL243γ4P yielded significantly greater inhibition ofproliferation than rituximab and the combination of rituximab andhL243γ4P yielded significantly more inhibition of proliferation thaneither MAb alone.

TABLE 9 Summary of antiproliferative activity of MAbs with and withoutcrosslinking (% Inhibition of 3-H-Thymidine uptake) Rituximab + hL243Rituximab hL243γ4P Antiproliferative activity of MAbs withoutcrosslinking Ramos 18.2 ± 4.9 −7.9 ± 3.6 10.1 ± 11.9 (0.0001)^(a)(0.3619) FSCCL 75.9 ± 10.2 13.4 ± 12.3 78.9 ± 1.7 (0.0028) (0.6611)Namalwa 50.1 ± 1.1 13.8 ± 5.6 27.8 ± 3.3 (0.0061) (0.0038)Antiproliferative activity of MAbs in the presence of anti-human 2^(nd)Ab Ramos 69.0 ± 7.0 50.5 ± 9.4 56.8 ± 0.8 (0.0519) (0.0073) FSCCL 94.5 ±0.9 28.1 ± 9.6 94.5 ± 0.8 (0.0067) (0.9984) Namalwa 58.1 ± 2.1 14.7 ±7.0 51.5 ± 3.0 (0.005) (0.0416) ^(a)Numbers in parentheses represent Pvalues of the single MAbs in comparison to the combination ofrituximab + hL243γ4P

Assessment of Apoptosis Induction

The mechanism of hL243 γ4P-induced cell death was evaluated by measuringvarious markers of apoptosis. These included induction of DNAfragmentation, Annexin V/7-AAD staining, measurement of activatedcaspase-3, loss of mitochondrial membrane potential and activation ofthe AKT survival pathway.

DNA fragmentation was evaluated by flow cytometry in SU-DHL-6 andNamalwa. Cells were cultured with the MAbs for 48 h with or without asecond MAb for crosslinking, followed by DNA staining with propidiumiodide. Cells were analyzed by flow cytometry, and positive florescencebelow the G1 region represents DNA fragmentation and is a measure ofapoptosis. Activity of hL243 γ4P was compared to that of humanized MAbsagainst other B cell antigens, including anti-CD74 (hLL1), anti CD22(hLL2, epratuzumab), anti-CD20 (hA20), as well as the murine-humanchimeric MAb rituximab. Controls included no first MAb and the negativecontrol humanized anti-CEA MAb, hMN-14. hL243 γ4P induced apoptosis inboth cell lines, at levels similar to or greater than the other anti-Bcell MAbs (FIGS. 18A and 21B).

A kit was used (eg the Guava Nexin™ kit) to discriminate betweenapoptotic and nonapoptotic dead cells in Daudi cells. The kit utilizesAnnexin-V-PE to detect phosphatidylserine (PS) on the external membraneof apoptotic cells and a cell impermeant dye 7-AAD as an indicator ofmembrane structural integrity. 7-AAD is excluded from live, healthycells and early apoptotic cells, but permeates late stage apoptotic anddead cells. As shown in FIG. 18B the results of this study indicatedthat hL243γ4P induced apoptosis similar to mL243 following both 4 h and24 h treatment. In contrast, the anti-CD20 MAb did not induce measurableapoptosis in Daudi cells. Therefore, hypercrosslinking by a secondaryagent, such as anti-human IgG or protein A may be used for induction ofapoptosis by anti-CD20 MAbs in many cell lines including Daudi.

In another example, the effects of humanized and murine L243 onmitochondrial potential was studied in different cells, namely,SU-DHL-6, Daudi, Raji, WSU-FSCCL, RL, and Namalwa. Results shown in FIG.19 indicate apoptotic changes in the mitochondrial membrane potentialwere observed with both murine and humanized L243 MAbs. Crosslinkingwith a second antibody may not be needed, but can increase the effect in2 of 6 cell lines evaluated, FSCCL and Namalwa. The loss ofmitochondrial membrane potential induced by hL243γ4P was greater thanthat of the anti-CD20 MAb (hA20), without a crosslinking agent. Withcrosslinking the hA20 levels are increased to those of hL243γ4P in 3 ofthe 6 cell lines (RL, SU-DHL-6, and Daudi).

Induction of activated caspase-3 by humanized and murine L243 wasassayed by flow cytometry in a panel of lymphoma cell lines. Resultsummarized in Table 10 show both the murine and humanized L243 induceactivation of caspase-3, at similar levels, in the absence ofcrosslinking with second antibody. The induction of activated caspase-3with the L243 MAbs is greater in all cell lines than that of hA20. Witha second antibody these levels are increased and the effect of hA20 issimilar to that of the hL243 □γ4P, except in Namalwa and FSCCL, two celllines which we routinely observe to be relatively insensitive toanti-CD20 MAbs. Cleaved caspase-3 was also assayed in Daudi over a 2 daytime course (FIG. 20A). The activity continues to increase forapproximately 2 days of L243γ4P incubation. Time points less than 1 hwere not done.

TABLE 10 Cleaved Caspase-3 assay Cleaved caspase-3 (% above no MAbcontrol) Humanized MAbs murine MAbs hL243g4P hA2 hMN-14 mL243 mMN-14 Nocrosslinking Ramos 26.9 3.2 0.8 15.8 3.9 Namalwa 18.4 −0.1 0.2 9.4 0.5FSCCL 46.4 0.7 0.3 26.2 −0.7 Daudi 48.1 7.9 0.9 45.8 1.0 RL 22.5 1.5−0.1 18.2 −0.3 SU-DHL-6 52.2 30.9 2.3 46.5 0.2 Raji 22.5 1.5 −0.1 18.2−0.3 with 2nd Ab Ramos 71.7 67.8 7.3 40.3 3.0 Namalwa 72.2 20.4 7.9 25.2−0.3 FSCCL 86.7 20.0 8.4 55.0 1.5 Daudi 68.9 72.0 2.9 51.2 0.0 RL 37.324.2 4.0 4.0 0.7 SU-DHL-6 72.1 75.8 5.5 51.4 −0.9 Raji 59.8 37.4 2.820.4 −0.3

The involvement of AKT in the mechanism of action of L243 was assayed in6 cell lines by flow cytometry. Cells were incubated with various MAbsfor 2 days, then assayed for phospho-AKT. The results listed in Table 11show that L243 activates AKT in all cell lines. Phospho-AKT levels inanti-CD20 (hA20) treated cells, as well as anti-CD74 and anti-CD22treated cells (not shown), are similar to untreated cells on all celllines. To determine the time course of P-AKT activation, Daudi cellswere incubated with MAbs for various times, MAbs were removed (bycentrifugation) at time points from 0 min to around 2 days (FIG. 20B).These results show activation of AKT by L243 can occur faster than canbe measured by this assay, because even at the zero time point P-AKTlevels are equal to the 2 day time point.

TABLE 11 P-AKT assay % above no MAb control humanized MAbs murine MAbshL243g4P hA2 hMN-14 mL243 mMN-14 Namalwa 8.4 −2.8 1.3 3.5 −4.4 FSCCL25.1 −1.4 3.9 16.3 −1.7 Daudi 34.9 1.0 −1.4 24.5 −2.1 RL 5.9 1.8 0.0 1.31.3 SU-DHL-6 29.8 0.2 1.2 26.1 −0.5 Raji 5.1 −0.9 −1.6 17.2 −4.2

In Vivo Therapeutic Efficacy of hL243 in a Xenograft Model ofNon-Hodgkin's Lymphoma (Raji)

A therapeutic study was performed to compare the in vivo efficacy ofhL243γ4P and mL243 (IgG2a isotype) monoclonal antibodies, in a xenograftmodel of human non-Hodgkin's lymphoma (Raji). The aim of this study wasto determine if hL243γ4P can maintain significant antitumor efficacy ina xenograft model. SCID mice were injected with 2.5×10⁶ Raji cells.Therapy with hL243γ4P or mL243 was initiated 1 day-post tumor celladministration. Results are shown in FIG. 21. Both groups of miceinjected with saline or with non-specific control antibody, hMN14, had amedian survival time (MST) of 17 days. All the groups of mice treatedwith either humanized or murine L243 had significantly improved lifespan compared to mice injected with saline or hMN14 (P<0.0001).Treatment with various doses of hL243γ4P resulted in a dose-responserelationship, with mice receiving higher doses having better survivaltimes. In the group of animals treated with various doses of mL243IgG2a, the cure rate was in the range of 80-100%.

Example 7 Anti-HLA-DR Antibody Therapy in Spontaneous Canine Lymphoma

Expression of HLA-DR on hematological malignancies has generatedconsiderable interest in its development as a target for antibody-basedtherapy. Here we describe the use of anti-HLA-DR monoclonal antibodies(mAbs), L243 and IMMU-114 (hL243γ4P), a humanized IgG4 mAb engineered toeliminate adverse reactions associated with complement-activation, forantibody therapy in dogs with lymphoma.

Normal and malignant canine B cell binding, induction of apoptosis,antibody-dependent cellular-cytotoxicity (ADCC), complement-dependentcytotoxicity (CDC), and direct cytotoxicity of L243 and IMMU-114 weremeasured in vitro. Safety and pharmacokinetic data on L243 and IMMU-114administration were collected in normal dogs, followed by a preliminarytrial of L243 in dogs with advanced lymphoma or unresectableplasmacytoma.

L243 and IMMU-114 were observed to bind to normal canine lymphocytes andcanine lymphoma cells. In vitro, murine L243 and IMMU-114 bindingyielded a reduction in viable cell counts and induction of apoptosis incanine lymphoma cells. When incubated with canine serum or peripheralblood mononuclear cells, L243, but not IMMU-114, induced CDC and ADCC,respectively. In vivo, both anti-HLA-DR mAbs can be administered safelyto dogs and bind to malignant cells. Evidence of clinical activity(hematopoietic toxicity and tumor response) was observed in dogs withadvanced-stage lymphoma following L243 immunotherapy.

To avoid complications associated with complement-dependent cytotoxicity(CDC) and antibody-dependent cellular cytotoxicity (ADCC), werecombinantly-engineered a humanized IgG4 construct of the murineanti-HLA-mAb, L243, referred to as hL243γ4P (IMMU-114) (Stein et al.,2006, Blood 108:2736-44). The IgG4 isotype was prepared because humanFcγ receptors are known to have low affinity for the human IgG4 isotope(Ravetch and Kinet, Ann Rev Immunol, 1991, 9:457-92). A point mutation,Ser241Pro, was introduced into the hinge region of the γ4 sequence inorder to avoid formation of half-molecules when the antibody isexpressed and produced in mammalian cell cultures, thus the designation,γ4P. As discussed in the preceding Examples, replacing the Fc region ofa humanized IgG1 anti-HLA-DR mAb with the IgG4 isotype abrogated theeffector cell functions of the antibody (ADCC and CDC), while theantigen-binding properties, anti-proliferative capacity (in vitro and invivo), and the ability to induce apoptosis concurrent with activation ofthe AKT survival pathway and other signaling pathway effects, wereretained. Thus, IMMU-114 is indistinguishable from the parental murinemAb and a humanized IgG1 anti-HLA-DR mAb in assays dependent uponantigen recognition. The abrogation of ADCC and CDC may be preferred forin vivo therapeutic use.

Materials and Methods

Antibodies.

The following mAbs were used for phenotyping: anti-CD3-FITC,anti-CD4-FITC, anti-CD8-PE, and B cell-PE, purchased from Serotec Ltd(Raleigh, N.C.), unlabeled anti-human CD22 (LL2) and anti-human CD74(LL1), supplied by Immunomedics, Inc. (Morris Plains, N.J.), unlabeledanti-human-CD3, -CD20, and -CD45 (Leu 4, Leu-16, and H-Le-1,respectively), purchased from BD Biosciences (San Jose, Calif.), andanti-CD20 mAbs, 2B8 and 1F5, purified from culture fluids of hybridomacells obtained from the American Type Culture Collection (ATCC,Manassas, Va.). Murine mAbs Ag8 (P3×63 Ag8, ATCC) and MN-14(anti-carcinoembryonic antigen [CEA, CEACAM5 or CD66e]) were used asisotype controls. L243 and humanized mAbs, IMMU-114 (hL243γ4P),milatuzumab (hLL1, anti-CD74 mAb) (Stein et al., Blood, 2004,104:3705-11), veltuzumab (hA20, anti-CD20) (Stein et al., Clin CancerRes, 2004, 10:2868-78), epratuzumab (hLL2, anti-CD22) (Leung et al.,Molecular Immunol, 1995, 32:1416-27), and labetuzumab (hMN-14, anti-CEA)(Sharkey et al., Cancer Res, 1995, 55:5935s-45s), were fromImmunomedics, Inc.

Flow Cytometry.

Peripheral blood lymphocyte subsets were determined using flowcytometry. The different leukocyte populations were identified by theirdistinctive position on forward and side scatter plots. The lymphocytepopulation was gated and 10,000 events were acquired for each antibody.All flow cytometry experiments were performed and analyzed using aFACSCalibur (Becton Dickinson, San Jose, Calif.). The data were analyzedwith CellQuest software. Immunostaining was performed according to themanufacturer's directions. Briefly, a 100-μl aliquot of whole blood inEDTA was incubated with either antibody or isotype control antibody for15 min at room temperature. Red blood cells were lysed with 2 ml of FACSlysing solution and incubated for 5 min. The cells were washed inphosphate-buffered saline (PBS), pH 7.4. The cell pellet was resuspendedin PBS containing 20 mM glucose and 1% bovine serum albumin andimmediately assayed by flow cytometry.

Determination of HLA-DR and CD20 antigen expression on normal andneoplastic cells was performed by indirect immunofluorescence assaysusing FITC-goat anti-mouse IgG (GAM, Invitrogen, Carlsbad, Calif.), asdescribed previously (Stein et al., Blood, 2006, 108:2736-44).

In Vitro Cytotoxicity and Apoptosis Assays.

Apoptosis was evaluated by flow cytometry. Briefly, cells were incubatedwith mAbs for 48 h with or without a second antibody for cross-linking,followed by DNA staining with propidium iodide. Samples were analyzed byflow cytometry using a FACSCalibur. Percentage of apoptotic cells wasdefined as the percentage of cells with DNA staining before G1/G0 peak(hypodiploid).

Standard ⁵¹Cr release assays were used to measure ADCC and CDC. Briefly,for CDC a ⅛ final dilution of canine serum was used as the source ofcomplement, followed by a 3-h incubation. Cells treated with 0.25%Triton X-100 were included as 100% lysis control, and cells treated withcomplement alone as 0% lysis. For ADCC, effector:target cell ratios ofapproximately 50:1 were used, and incubations were for 4 h. All assayswere performed in triplicate.

In Vivo Studies.

Sterile antibodies were diluted in a total volume of 90 ml and 250 ml of0.9% NaCl for administration to normal dogs and dogs with lymphoma,respectively. All dogs were pre-medicated with 4 mg/kg diphenhydramineintramuscularly 20 min prior to antibody infusion. The dogs weremonitored continuously during the infusion, and vital signs and bodytemperature were recorded every 30 min. If adverse events (vomiting,erythema, pruritus, weakness, tachycardia) were observed, the infusionwas stopped for at least 15 min and restarted at half the initialinfusion rate. The normal dogs' rectal temperature was taken twice dailyfor 7 days following each antibody infusion. Adverse events were gradedaccording to the veterinary co-operative group—common terminologycriteria (Veterinary co-operative oncology group, Vet Comparative Oncol,2004, 2:194-213).

Normal Dogs.

Intact female beagle dogs were used to assess systemic toxicity withL243 (2 dogs) and IMMU-114 (2 dogs) antibody administration. The dogswere deemed healthy based on physical examination, complete blood cellcount, biochemical profile, and urinalysis. L243 was administered at 1.5mg/kg of body weight over a planned 90-min interval to the first dog.This dose was extrapolated from previous dose ranging studies in mice.The antibody infusion was repeated on day-7 in this dog. The dose ofL243 was increased to 3 mg/kg for the second dog, since there wasminimal toxicity noted in dog-1. The second dose was repeated on day-2rather than day-7, to determine if increased toxicity would be detectedwith a shorter interval between treatments. IMMU-114 was administered at3 mg/kg infused over a 90-min period to 2 dogs. One of the dogs wasinfused a second time 2 weeks later at 1.3 mg/kg.

Blood was collected into ethylenediamine tetraacetic acid (EDTA) tubesfor complete blood cell counts and peripheral blood lymphocytephenotyping at 4, 24, 48, and 72 h and at 7, 14, 21 days after the firstinfusion. Biochemical profiles and urine were analyzed at 7, 14, and 21days after the first infusion. Dogs were humanely euthanized byintravenous pentobarbital sodium injection 30 days after the firstinfusion. Necropsies were performed post mortem and tissue samples werecollected in formalin for histologic review by a board certifiedpathologist.

Dogs with Lymphoma.

Dogs were enrolled in this study if they had histologic or cytologicconfirmation of lymphoma or plasma cell neoplasia and had previouslyfailed or were refractory to conventional cytotoxic chemotherapy or ifthe owner had declined other therapy. Chemotherapy was not administeredconcurrently or less than 3 weeks prior to treatment with HLA-DR mAb.Pretreatment evaluation for all tumor-bearing dogs included physicalexamination, complete blood cell count, biochemical profile, andurinalysis. Dogs were excluded if there was evidence of ≧grade 2toxicity on screening studies. Lymph nodes or tumors were measured in 3dimensions and tumor volume was calculated as the product of length,width, height, π/6. Dogs received 1 to 4 treatments administered at2-week intervals at a dosage of 3 mg/kg intravenously. Based on thenormal dog studies above, the starting protocol for infusion of L243 wasplanned over a 4-h period. Due to delays caused by infusion reaction insome of the dogs, the infusion was slowed to 3 mg/kg over 12 h. Adverseinfusion events were monitored continuously in an intensive care settingduring the infusion. Complete blood cell count, chemistry profile,urinalysis and tumor measurements were evaluated weekly.

Enzyme-Linked Immunoabsorbent Assay (ELISA).

L243 and IMMU-114 serum levels were measured by ELISA. Two ml of wholeblood were collected pretreatment, at the end of the antibody infusion,1 h after the end of the infusion and at 24 h. The samples were allowedto clot at room temperature for 30 min and the serum was separated andfrozen at −80° C. prior to analysis. The ELISA assays were performed in96-well PVC microtiter plates. Plates were coated overnight with goatanti-mouse IgG F(ab′)₂ fragment specific antibody at 10 μg/ml in PBS,0.02% NaN₃ (Jackson Immunoresearch, West Grove, Pa.), then blocked with1% BSA/PBS, 0.02% NaN₃ for 1 h at room temperature. Triplicate serumdilutions (in 1% BSA/PBS, 0.02% NaN₃ at ⅓, 1/10, 1/30, and 1/100) wereincubated for 1 h in the coated wells. A standard curve of L243 orIMMU-114 was run in the same plate. After washing with PBS, 0.05% Tween,peroxidase conjugated goat anti-mouse (or anti-human) IgG, Fcγ specificantibody (1:3000 dilution in 1% BSA/PBS, Jackson Immunoresearch) wasadded and the plate was incubated for an additional 1 h at roomtemperature in the dark. The plates were washed, developed witho-phenylenediamine dihydrochloride substrate solution and read at 490nm, after stopping the reaction by adding 1.5 N H₂SO₄.

Statistics.

P-values were calculated using the Student's t test. Two-sided testswere used throughout. Values less than 0.05 are considered statisticallysignificant. For ADCC and CDC assays, P values were calculated versusthe no-antibody control.

Results

In Vitro Effects of L243 on Proliferation and Apoptosis.

Lymph node aspirates from four dogs with lymphoma were incubated withmAb L243 in vitro to determine the effects of the mAb on proliferationand apoptosis. All four specimens were positive for L243 binding (FIG.22A). Induction of apoptosis by L243 was evaluated by flow cytometryassays measuring hypodiploid DNA. Cells were cultured with the mAbs for48 h with or without a second mAb for cross-linking, followed by DNAstaining with propidium iodide. Cells were analyzed by flow cytometry,and positive fluorescence below the G0/G1 region represents DNAfragmentation and is a measure of apoptosis. As shown in FIG. 22B, L243caused specific induction of apoptosis in the presence of goatanti-mouse IgG second antibody (P<0.05 vs. crosslinked isotype control)in all four specimens. Viable cell counts were measured after 2-dayincubations of the tumor aspirates with L243 plus goat anti-mouse IgGsecond antibody. Decreases in the viable tumor cell population of 43%(P=0.0088) and 23% (P=0.097) were obtained in specimens 160812 and160965, respectively, vs. Ag8 plus goat anti-mouse IgG second antibody(FIG. 22C). Specimens 160540 and 150836 were not tested by this assay.ADCC and CDC assays were performed on one tumor aspirate, from dog171205, using PBMCs or serum isolated from that animal as sources ofeffector cells and complement, respectively. Statistically significantlysis was observed with L243 but not an isotype control (MN-14) in bothassays. For CDC, lysis was 38.1%±0.9% (P=0.0004) and 1.1±2.2% (P=1.0000)for L243 and isotype control, respectively. For ADCC, lysis was26.6±15.9% (P=0.0319) and -6.9±18.36% (P=0.4544) for L243 and isotypecontrol, respectively. Thus, crosslinked L243 yields a specifictherapeutic effect on canine lymphoma aspirates, leading to a reductionin viable cell count and induction of apoptosis, as measured by DNAfragmentation. When incubated with dog serum or PBMCs, L243 induces CDCand ADCC.

We also demonstrated that IMMU-114 (humanized, engineered L243) binds tocanine lymphoma cells (Table 12). In addition, IMMU-114 inducesapoptosis in the canine lymphoma cells when crosslinked with ananti-human IgG second antibody (FIG. 23A). Evaluation of the ability ofIMMU-114 to induce CDC and ADCC was performed on one canine lymphomaaspirate (171205). As shown in FIGS. 23B and 23C, murine L243 but notIMMU-114 yielded specific cell lysis of the dog lymphoma cells,confirming the lack of CDC and ADCC effector functions of IMMU-114.

TABLE 12 Characteristic phenotype of a canine lymphoma aspirate(150836). Murine % Mean Humanized % Mean Abs Positive FL mAbs PositiveFL None 3.9 3.4 none 4.5 3.2 Ag8 2.8 3.0 hMN-14 4.6 3.2 L243 77.8 10.4IMMU-114 26.2 5.5 2B8 2.6 3.1 hA20 4.0 3.3 (anti-CD20) (anti-CD20) LL16.7 4.0 hLL1 4.7 3.3 (anti-CD74) (anti-CD74) LL2 5.1 3.7 hLL2 4.9 3.4(anti-CD22) (anti-CD22)

L243 Administration In Vivo.

Safety data on L243 infusion was collected in two normal dogs, followedby a trial in 6 dogs with relapsed lymphoma, and 1 dog with anunresectable plasmacytoma.

Normal Dogs.

Dog 1 received 2 infusions of 1.5 mg/kg, 7 days apart. An infusionalreaction occurred during the first antibody administration that includedgrade I nausea/vomiting and grade I fever. Decreasing the infusion rateby 50% (from an initial rate of 0.2 mg/ml/min) eliminated the adversereactions. There were no adverse events during the second infusion. Dog2 received 2 infusions of 3.0 mg/kg, 48 hours apart (0.25 mg/ml/min).There were no adverse reactions during either infusion. There were nosignificant changes in the post-infusion biochemical profiles orurinalysis in either dog. Mature neutrophils were transiently elevatedin Dog 2 (13.3×10³/μl; normal range 3.4-9.7×10³/μl) 24 h after the firstinfusion and normalized within 24 h. Both dogs had a marked transientincrease in band neutrophils. Dog 1 had 1000/μl band neutrophils 4 hafter the second infusion (normal range 0-100/μl); Dog 2 had 1300/μlband neutrophils 24 h after the first infusion. Both dogs had normalband neutrophil counts 24 h later. Lymphopenia (800/μl-dog 1, 500/μl-dog2: normal range 1000-4000/μl) was noted 4-24 h following the firstinfusion in both dogs and following the second infusion in dog 2.Lymphocytes returned to normal within approximately 1 week followinginfusion. Peripheral blood lymphocyte subset phenotyping indicated adecrease in both B and T cell lymphocytes (FIG. 24). Such rapid changesin neutrophils and lymphocytes represent a non-specific component toimmunogens in dogs. Resolution of the neutrophilia occurred within oneday and lymphocyte populations recovered over a 7-day period. Completenecropsy examination of Dogs 1 and 2 did not reveal any gross orhistologic abnormalities.

Tumor-Bearing Dogs.

Seven dogs with lymphoma/plasmacytoma were treated with L243. The medianage of the patients was 10.8 years (range 8.4-11.9 years). The medianbody weight was 35 kg (range 12.6-51.2 kg). There were 4 male dogs (2intact, 2 castrated), and 3 female dogs (all spayed). Four of the dogshad B cell lymphoma, 2 had T-cell lymphoma, and 1 had an unresectableplasmacytoma. All dogs were staged according to WHO guidelines forcanine lymphoma: 3 were stage V, 2 were stage III, and one remainedincompletely staged. Four of the six lymphoma patients had failedinitial conventional and rescue chemotherapy treatments. The remainingtwo lymphoma patients had received prednisone as their only therapyprior to presentation and their owners' had declined standardchemotherapy. All previous chemotherapeutic agents were discontinued 2-4weeks prior to L243 therapy.

Toxicity.

Infusional side-effects were common with 6/7 patients, experiencinggrade 1 nausea or vomiting and 5/7 experiencing grade 1 fever. Slowingthe infusion rate abrogated the adverse reactions. Two dogs receiveddexamethasone at 0.5-2 mg/kg i.v. due to vomiting and elevatedtemperature. No dog had treatment discontinued due to adverse events.Hematologic toxicity was noted in 3/7 patients. One dog had grade 1neutropenia and grade 1 thrombocytopenia two weeks after the firstinfusion. This dog received a total of 3 treatments and did not exhibitany additional hematologic abnormalities. In two dogs, grade 3neutropenia and grade 4 thrombocytopenia were observed one week afterthe second infusion. Both of these dogs were heavily pretreated withchemotherapy prior to antibody infusion. Bone marrow aspirates indicateda non-specific granulocytic and megakaryocytic hypoplasia. One dog waseuthanized due to hemorrhage from multiple ulcerated cutaneous lymphomalesions. The second dog's cytopenias resolved uneventfully by the fourthweek post infusion. One dog died suddenly at home approximately 5 daysafter L243 therapy due to rapidly progressing, resistant lymphoma. Anecropsy was not performed.

Response to Therapy.

Two dogs with advanced, multicentric B cell lymphoma had a transientresponse to L243 therapy. One dog had stable disease with completeresolution of circulating lymphoblasts for 5 weeks following the secondinfusion, with improvement in attitude and appetite. This dog received atotal of three treatments. His disease progressed 8 weeks after hisfirst L243 treatment. The second dog had a 50% reduction in the size ofperipheral lymph nodes observed by physical examination and measurementof peripheral lymph node volume one week after the first treatment. Thepartial response lasted 8 weeks before progressive disease was noted.This dog received a total of 4 treatments without evidence of anytoxicity. Both dogs received a brief course (1-2 weeks) ofcorticosteroid prior to L243 therapy. In each instance, the dogs hadprogressive disease on corticosteroids prior to L243 infusion and allcorticosteroid therapy was discontinued before treatment.

A comparison of cells aspirated from a lymph node prior to L243 withcells obtained one week after the first L243 infusion was performed inorder to assess in vivo targeting of the L243 mAb. The histogramsrepresented baseline and one-week post infusion aspirated cells, towhich no first or second antibodies were added in vitro (not shown). Theprofiles of the baseline cells and week-1 cells overlapped (not shown).The cells were incubated in vitro with FITC-labeled GAM, to detect cellsthat were labeled with L243 in vivo (not shown). Cells obtained from thesame lymph node 1 week after treatment with L243 were shifted to theright of the baseline cells, demonstrating the binding of murine IgG tothe cell surface (not shown). The cells were incubated in vitro withL243 and FITC-GAM to determine whether the cells were saturated with mAbL243. Aspirated cells taken 1 week after treatment with L243 coincidedwith the baseline cells because the in vivo and in vitro binding of L243IgG to the cell surface are indistinguishable after saturating doses ofL243 (not shown). Both groups exhibited higher mean fluorescencecompared to that of the FITC-GAM labeled cells, indicating that the invivo L243 dose administered did not saturate all malignant cells in thenode (not shown). Data obtained from cells aspirated 2 weeks afterinfusion continue to demonstrated L243 binding to malignant lymphocytes(not shown). An alternate explanation is that some of the bound L243 wasinternalized or processed, and the antigen remains on or returns to thecell surface, able to bind additional antibody. Cells were incubated invitro with Ag8 (isotype matched, nonspecific mAb) and FITC-GAM.Aspirated cells taken 1 week after infusion with L243 were shifted tothe right of the baseline cells, again demonstrating the binding ofmurine IgG to the cell surface (not shown). Only the cells labeled invivo with L243 bind to the FITC-GAM, because Ag8 does not bind to thecells. This assay demonstrated that L243 targeted the tumor cells invivo.

The L243 antibody was measured by ELISA in the serum of the last treateddog (152616). Samples were collected prior to the antibody infusion, atthe end of the infusion, 1 h post infusion and at 24 h at each of the 4treatments (FIG. 25). The serum level of L243 detected after the secondinfusion was markedly higher than after the first infusion. Thissuggests that the antigen pool present on cell surfaces was eitherblocked or eliminated by the first infusion. Infusions 3 and 4 yieldedprogressively lower serum concentrations of L243. This was likely due toan anti-antibody response causing rapid clearance of the infused murineL243 antibody. Because the presence of anti-mouse IgG was not measured,reappearance of an antigen sink cannot be ruled out.

IMMU-114 Administration In Vivo.

Once IMMU-114, the humanized reengineered IgG4 form of murine L243,became available, it was administered to 2 normal beagles at 3 mg/kgover 90 min. There was no infusion reaction noted in either dog duringthe infusion. One of the dogs was infused a second time 2 weeks later(at 1.3 mg/kg). A mild infusion reaction that included head shaking,mild fever and vomiting occurred following the second infusion. Theseverity of the reaction was lessened by slowing the rate of theinfusion. This may suggest the development of anti-human IMMU-114antibody. CBCs and biochemical panels were conducted with no significantchanges noted over a 2-week period, with the exception of a transientlymphopenia as also observed with L243 infusion. Pharmacokinetic (PK)data obtained at the end of infusion, and 1, 4, 24, 48, 72 h, 1 week,and 2 weeks post-infusion indicated a rapid clearance within the firstfew hours, with about 50% of the IMMU-114 antibody cleared within 2 h,and with the remaining antibody clearing with a half-life of ˜2 days(FIG. 25).

Discussion

Naturally-occurring lymphoma in dogs is extremely common and has beenvalidated as a useful model of high-grade, B cell, non-Hodgkin'slymphoma in humans. Conventional chemotherapeutic management of lymphomain dogs, as in humans, is limited with 5-20% 2-year survival ratesfollowing CHOP-based chemotherapeutic protocols. The availability ofcanine lymphoma patients, the ability to investigate novel strategieswith repeated sampling of normal and tumor tissue or fluid, as well asthe design of rigorous clinical trials to determine relevant therapeuticendpoints, are recognized advantages of this model as a bridge frompreclinical investigations to humans. Although anti-CD20 antibodies havecontributed to improved outcomes in some forms of lymphoma in humans,the commercially available human anti-CD20 antibodies do not bindsufficiently with canine B cell lymphomas to permit furtherinvestigations of this strategy. However, substantial opportunitiesexist to expand the investigation of other antibody-based immunologictherapeutics.

Lymphoma is an increasingly common form of cancer with a wide range ofimmunologic and genetic subcategories with equally diverse prognoses.Aggressive forms of non-Hodgkin's lymphoma are currently controlled withchemotherapy with or without antibody infusions with only a moderatedegree of success. Novel immunotherapeutic approaches, such as infusionof anti-B cell mAbs to improve the management of lymphoma, aretraditionally examined in murine models but should be more carefullyevaluated prior to human study to identify and better anticipate theimpact of such interventions. Studies in the present canine model areimportant to the translation of IMMU-114 to clinical studies in humans,particularly given the prior clinical experience with anotheranti-HLA-DR antibody (Hu1D10; apolizumab), where moderate to severe sideeffects, primarily related to robust immune effector activity (e.g.,mainly CDC) limited its dosing (Shi et al., Leuk Lymphoma, 2002,43:1303-12. In order to expedite the scientific and practical decisionsabout progression of new immunotherapeutic strategies into humans with Bcell malignancies, prudent use of the canine lymphoma model to addressboth safety and efficacy represents a truly comparative approach tocancer investigation.

The effects of anti-HLA-DR antibodies on malignant cells have beenstudied extensively. The most widely recognized function of class IImajor histocompatibilty complex (MHC) molecules is the recognition offoreign antigen fragments and presentation to CD4 T lymphocytes. Inaddition, signals delivered via HLA-DR molecules contribute to thefunctioning of the immune system by up-regulating the activity ofadhesion molecules, inducing T-cell antigen counter receptors, andinitiating the synthesis of cytokines. Stimulation of HLA molecules byantibodies has been shown to affect growth, differentiation, andimmunoglobulin secretion by B lymphocytes, as well as production ofcytokines, modulation of expression of growth factor receptors, celladhesion, and co-stimulatory molecules by B cells and monocytes (Nagy etal., J Mol Med, 2003, 81:757-65). HLA molecules have also been shown toserve as receptors that activate various cell death pathways, includingcaspase-dependent and caspase-independent alternative pathways ofapoptosis (Nagy et al., J Mol Med, 2003, 81:757-65; Mone et al., Blood,2004, 103:1846-54; Newell et al., PNAS USA 1993, 90:10459-63; Truman etal., Blood, 1997, 89:1996-2007). Functions reported to be affected byincubation of cells with L243 have included signal transduction, growthinhibition, Fas-mediated apoptosis, interactions with actinmicrofilaments, TNF-α and TNF-β gene expression, cell adhesion, ADCC,and others (see, e.g., Nagy et al., J Mol Med, 2003, 81:757-65; Mone etal., Blood, 2004, 103:1846-54; Newell et al., PNAS USA 1993,90:10459-63; Truman et al., Blood, 1997, 89:1996-2007; Altomonte et al.,J Cell Physiol, 2004, 200:272-6; Aoudjit et al., Exp Cell Res 2004,299:79-90; Guo et al., Hum Immunol, 1999, 60:312-22). Enhanced cell killover rituximab alone is demonstrated when the IMMU-114, is combined withrituximab in vitro (Stein et al., 2006, 108:2736-44). Recent studieshave shown that antigen expression is not sufficient for cytotoxicity,but that antibody-induced activation of extracellular signal-regulatedkinase (ERK) and c-Jun N-terminal kinase (JNK) stress signaling pathwaysare also required (Stein et al., unpublished).

The results reported here show that the anti-HLA-DR antibodies, L243 andIMMU-114, are able to induce cell death of canine lymphoma cells invitro and can be given safely to dogs with lymphoma that are not heavilypretreated with chemotherapy. From this study, we were able to obtainvaluable information regarding the dose and infusion rate for caninepatients diagnosed with B cell lymphomas. The primary reaction followinginitiation of the infusion was mild and was characterized by a grade 1fever and grade 1 nausea/vomiting. Myelosuppression was only noted incanine patients that were heavily pretreated with other chemotherapeuticagents. No other severe acute reactions were observed.

Two dogs with T-cell lymphoma were treated. Our preliminary workdemonstrated that the T-cell form of lymphoma did not bind L243significantly. We chose to enroll these dogs to identify whether theinfusion reaction may be non-specific in an L243-negative tumor. Neitherdog expressed the L243 antigen on the tumor cells. Both of these dogsexperienced similar infusion reactions to those dogs with L243+ B celltumors.

All dogs had tumor measurements and were evaluated for response. The twodogs with B cell lymphoma that had received prednisone as their onlyprior therapy experienced measurable responses to L243. One experienceda minor, but measurable, response with significant improvement ofadvanced symptoms, while the second had a partial response lasting 8weeks. Five dogs did not demonstrate an obvious tumor response. Dogs inthis group were L243-negative (T-cell lymphoma) or had end-stage diseaseat the time of treatment.

In vitro studies showed that murine L243 and its humanized IgG4construct, IMMU-114, bind to normal and malignant canine lymphocytes andsubsequently induce biological activity. In vivo studies indicate thatthe murine and humanized mAbs can be administered safely to dogs withlymphoma and bind to the malignant cells in nodal tissue. Preliminaryevidence of disease stabilization was observed in dogs withadvanced-stage lymphoma following anti-HLA-DR immunotherapy.

Example 8 Comparative Effects of Different Specificity Antibodies

The cross-reactivity of a panel of anti-human B cell mAbs with doglymphocytes was evaluated using peripheral blood from a healthy dog. Ahuman blood sample was tested at the same time as a control. Singlecolor indirect flow cytometry analysis was performed. Reactivity of themAb panel with the human lymphocytes was within the expected range. MAbsagainst human CD20 (1F5) and HLA-DR (L243) reacted with the doglymphocytes. Anti-human CD22 (LL2), CD74 (LL1), and mAbs recognizinghuman CD3 (Leu 4), CD20 (Leu-16), and CD45 (H-Le-1) did not cross-reactwith dog lymphocytes. Based on these initial results, tumor aspiratesobtained through a large gauge needle from dogs with lymphoma weretested for binding to anti-HLA-DR and anti-CD20 murine mAbs. Anti-HLA-DR(L243) was positive in 32/35 samples (greater than 5 units above theisotype control) and strongly positive (greater than 10 units above thenegative control) in 30/35 samples. In contrast, anti-CD20 (2B8 used inthese studies) was positive in 5/21, including 3 strongly positive.Reactivity of L243 was confirmed on the peripheral blood of several ofthese dogs.

The comparative effect of the different specificity antibodies onsurvival of mice injected with WSU-FSCCL tumor cells is shown in FIG.26. The mL243 and hL243γ4P antibodies produced a significant increase insurvival compared to the other antibodies tested.

We examined the reactivity and cytotoxicity of hL243γ4P on a panel ofleukemia cell lines. hL243γ4P bound to the cell surface of 2/3 AML, 2/2mantle cell, 4/4 ALL, 1/1 hairy cell leukemia, and 2/2 CLL cell lines,but not on the 1 CML cell line tested. Cytotoxicity assays demonstratedthat hL243γ4P was toxic to 2/2 mantle cell, 2/2 CLL, 3/4 ALL, and 1/1hairy cell leukemia cell lines, but did not kill 3/3 AML cell linesdespite positive staining. As expected, the CML cell line was also notkilled by hL243γ4P.

Additional comparative data for different antibodies tested against avariety of NHL cell lines is presented in Table 13. Table 14 shows therelative expression of HLA-DR compared with CD74, CD22 and CD20 indifferent tumor types. Table 15 illustrates the relative cytotoxicity ofhL243γ4P compared to other anti-B cell mAbs in different tumor types.The percent of untreated values in MTT assay are shown. Highlightedvalues represent a significant decrease from untreated (P<0.05). HLA-DRis expressed on all B-lymphoma and leukemia tested cell lines atmarkedly higher levels than CD20, CD22, and CD74. Despite positivestaining AML cell lines are not killed by hL243g4P. Variation inexpression and cytotoxicity profiles between the mAbs suggests thatcombination therapies may yield greater effects than the mAbs givensingly.

TABLE 13 Comparative reaction of different specificity antibodies withNHL cell lines NHL Cell Line Murine MAb RL Raji Ramos SU-DHL6 Daudi Ag8(neg control) 3.3 2.6 4.6 2.5 6.9 L243 (HLA-DR) 157.2 623.7 92.9 370.3435.5 LL1 (CD74) 7.5 63.8 12.3 27.9 26.4 LL2 (CD22) 5.4 30.8 10.7 9.743.5 2B8 (CD20) 46.7 102.7 64.2 148.8 101.5

TABLE 14 Expression of HLA-DR compared to CD74, CD22 and CD20 (mean FL)Ag8 L243 No (Isotype (HLA- LL1 LL2 2B8 Cell line mAb control) DR) (CD74)(CD22) (CD20) AML GDM-1 16.8 20.1 1072.7 69.5 28.5 15.6 Kasumi-1 18.217.0 24.0 23.8 20.9 14.5 Kasumi-3 9.6 15.7 565.3 18.4 13.9 11.0 MCLJeko-1 14.3 17.4 1895.0 32.7 25.0 454.8 Granta- 15.3 16.9 2107.9 50.828.6 677.2 519 ALL RS4;11 6.4 8.6 152.0 24.3 20.9 11.5 REH 3.9 3.92088.4 61.1 16.8 23.5 697 4.9 5.6 259.3 20.6 15.9 6.9 MN60 8.1 10.51221.1 25.9 17.1 162.4 CML K562 3.2 4.1 4.9 7.0 4.3 4.3 Hairy HC-1 4.83.5 514.9 36.7 17.8 42.2 cell leuke- mia CLL MEC-1 4.7 6.0 1700.5 44.749.0 175.3 WAC 15.8 14.4 787.5 43.6 20.1 275.4

TABLE 15 Cytotoxicity of hL243γ4P compared to other anti-B cell mAbs

FIG. 27 illustrates the ex vivo effects of various antibodies on wholeblood. hL243γ4P resulted in significantly less B cell depletion thanrituximab and veltuzumab, consistent with an earlier report (Nagy, etal, J Mol Med 2003; 81:757-65) which suggested that anti-HLA-DR mAbskill activated, but not resting normal B cells, in addition to tumorcells. This suggests a dual requirement for both MHC-II expression andcell activation for antibody-induced death, and implies that because themajority of peripheral B cells are resting, the potential side effectdue to killing of normal B cells may be minimal. T-cells are unaffected.

The effects of ERK, JNK and ROS inhibitors on hL243γ4P mediatedapoptosis in Raji cells is shown in FIG. 28. hL243γ4P cytotoxicitycorrelates with activation of ERK and JNK signaling and differentiatesthe mechanism of action of hL243γ4P cytotoxicity from that of anti-CD20mAbs. hL243γ4P also changes mitochondrial membrane potential andgenerates ROS in Raji cells (not shown). Inhibition of ERK, JNK, or ROSby specific inhibitors partially abrogates the apoptosis. Inhibition of2 or more pathways abolishes the apoptosis.

These data demonstrate that hL243g4P may be useful in the treatment ofmantle cell lymphoma, ALL, hairy cell leukemia, and CLL, as well as NHLand multiple myeloma.

Example 9 Purification of hL243 Anti-HLA-DR Antibody

The hL243 anti-HLA-DR antibody was designed, constructed, cloned andtransfected into myeloma host cells as described in U.S. Pat. No.7,612,180, the Examples section of which is incorporated herein byreference.

The purification process for hL243 IgG featured chromatography on threesequential columns of Protein A, Q-SEPHAROSE® and SP-SEPHAROSE®.Although SEPHAROSE® is used as an exemplary column chromatography resin,the skilled artisan will realize that alternative methods ofchromatography and alternative chromatography resins are known in theart and may be used. Further, the anion and cation exchange steps arenot limited to Q-SEPHAROSE® and SP-SEPHAROSE®, but may also utilizeother anion- and cation-exchange resins known in the art. The last stepof the process utilizes a DV20 virus removal filtration, after which theproduct is tested for sterility.

The Protein A affinity resin used for the first column, MABSELECT™ (GEHealthcare, Piscataway, N.J.) has a binding capacity of 25-30 mg/mL. Theresin was packed up to a 20 cm height in a 20 cm diameter column to apacked bed volume of 6.3 L, with a maximum loading capacity of 220 gm.Before the antibody containing culture medium was loaded, the packedcolumn was sanitized with 0.1 M acetic acid in 20% ethanol and thenre-generated with 0.04 M PBS, pH 7.4. After equilibration, thesupernatant was loaded at a maximum flow rate of 300 cm/hr. The columnwas washed with 0.04 M PBS, pH 7.4, until the absorbance returned tobaseline, followed by washing with another 5 bed volumes of 0.04 M PBS,pH 7.4 at 300 cm/hr.

The bound IgG was eluted with 0.1 M citrate, pH 3.5, at a maximum flowrate of 300 cm/hr. The elution profile was monitored by absorbance at280 nm, using a flow through spectrophotometer. The collected productpeak was neutralized to pH 7.0-8.0 using 3 M Tris/HCl, pH 8.6. As anadditional virus removal step, the neutralized product peak was titratedto pH 3.5-3.7 using 1 M citric acid. This mixture was incubated at roomtemperature for four hours and at the end of the incubation, it wasneutralized to pH 7.0-8.0 using 3 M Tris/HCl, pH 8.6.

The mixture was then concentrated to 5-7 mg/mL and diafiltered into 0.02M Tris/HCl, 0.05 M NaCl, pH 7.5, in preparation for the nextpurification step. The diafiltered Protein A purified hLL2 IgG wasfiltered through a 0.2 μm filter and stored at 2-8° C., before loadingonto the Q-SEPHAROSE® column.

The anion exchange resin used for the next column was Q-SEPHAROSE® fastflow resin (GE Healthcare, Piscataway, N.J.). The resin was packed up toa 20 cm height in a 30 cm diameter column, to a packed bed volume of14.1 L with a maximum loading capacity of 300 gm. Before the Protein Apurified IgG was loaded, the packed column was sanitized with 1 M sodiumhydroxide and then regenerated with 0.02 M Tris/HCl, 1.0 M NaCl, pH 8.0.The resin was then equilibrated with 0.02 M Tris/HCl, 0.05 M NaCl, pH7.5. The diafiltered Protein A purified IgG was loaded at a flow rate of100 cm/hr and the flow through peak was eluted with 0.02 M Tris/HCl,0.05 M NaCl, pH 7.5 at a maximum flow rate of 300 cm/hr. Thecontaminants eluted from the Protein A column bound to the Q-SEPHAROSE®resin. The Q-SEPHAROSE® purified IgG was filtered using a 0.2-μm filterand stored at 2-8° C. until further purification. Before loading ontothe final column, the IgG was titrated to pH 5.0 using 1 M citric acid.

The cation exchange resin used for the last column was SP-SEPHAROSE®fast flow resin (GE Healthcare, Piscataway, N.J.). The resin was packedup to a 20 cm height in a 20 cm diameter column, with a maximum loadingcapacity of 220 gm. Before the Q-SEPHAROSE® purified hLL2 IgG wasloaded, the packed column was sanitized with 1 M sodium hydroxide andthen equilibrated with 0.025 M citrate, pH 5.0. The IgG was loaded at amaximum flow rate of 300 cm/hr and the column was washed with 5 bedvolumes of 0.025 M citrate, pH 5.0, at 300 cm/hr. After loading andwashing, the IgG was eluted with 0.025 M citrate, 0.15 M NaCl, pH 6.0.The elution profile was monitored by absorbance at 280 nm.

The purified hL243 IgG was concentrated to 10-11 mg/mL and diafilteredinto 0.04 M PBS, pH 7.4, then filtered through 0.2 and 0.1 μm filtersbefore DV₂₀ filtration. After filtration, 75 mL of 0.04 M PBS, 1%Polysorbate 80, pH 7.4 was added to every liter of purified IgG and themixture was filtered again through a 0.2 μm filter before storage at2°−8° C.

Example 10 Ultrafiltration Concentration of Humanized Antibodies in HighConcentration Formulation Buffer

Using ultrafiltration, humanized IgG was concentrated to at least 200mg/mL in High Concentration Formulation (HCF) buffer, with minimal or noaggregation. A series of analytical assays were performed to monitor anychanges during the concentration process. No detectable changes inantibody quality or solution characteristics were observed. The liquidformulation was stable at 2-8° C. for at least 12 months. The stabilityestimated at 12 months by SE-HPLC (which showed essentially a singlepeak on the absorbance trace) was between 97 and 99%. Reducing andnon-reducing PAGE was consistent with the HPLC results (not shown). Theformulation is suitable for subcutaneous injection (SQ). Exemplaryantibodies tested include milatuzumab (hLL1, anti-CD74), epratuzumab(hLL2, anti-CD22), veltuzumab (hA20, anti-CD20) and hL243 (anti-HLA-DR;IMMU-114).

A High Concentration Formulation (HCF) buffer was developed that wasdemonstrated to be capable of stabilizing antibody solutions to at least200 mg/mL concentration (Table 16). In addition to phosphate buffer andNaCl from IV formulation, this SQ formulation contains mannitol whichhas been of use in protein formulations for maintaining stability andisotonicity, and Polysorbate 80 (PS-80) which protects antibodiesagainst aggregation. Since the pI value of most humanized IgG1antibodies is between 8-9.5, a citric acid/sodium citrate buffer system(buffering range 2.5-5.6) and a low pH (5.2) were used to ensure theprotein is in charged form, and thus more stable in solution.

During ultrafiltration a 50 KD MW cut-off membrane was used, whichretained and concentrated the 150 kD IgG molecules while allowing waterand small molecules in the formulation buffer to pass through.

TABLE 16 High Concentration Formulation Compositions hLL1 hLL12 hA20(Milatuzumab, (Epratuzumab, (Veltuzumab, hL243 Component anti-CD74)anti-CD22) anti-CD20) (anti-HLA-DR) IgG₁ 213 mg/mL 109 mg/mL 162 mg/ml101 mg/mL Na₂HPO₄•7H₂O 2.30 g NaH₂PO₄•H₂O 0.76 g Sodium Chloride 6.16 gPolysorbate 80 (w/v) 1.0 mL (polysobate-80 was added at the end of theconcentration step) Sodium Citrate 0.34 g Dihydrate Citric Acid 1.3 gMonohydrate Mannitol 12.0 g WFI (qs) 1 L pH (adjusted by 5.2 NaOH)

The solute concentrations of HCF buffer were 6.2 mM citric acidmonohydrate, 105 mM sodium chloride, 1.2 mM sodium citrate dihydrate,8.7 mM sodium phosphate dibasic, 5.5 mM sodium phosphate monobasic, 66mM mannitol, pH 5.2, conductivity 11.0-14.0 mS/cm.

An AMICON® Model 8050 Stirred Ultrafiltration Cell (from MILLIPORE®, 50mL max volume) was used with a 50 kD polyethersulfone filter NMWL (fromMILLIPORE®, diameter 44.5 mm) to concentrate the antibodies. Ultra pureargon gas was used to pressurize the system.

The UF-cell with a 50KD membrane was assembled and connected to theargon gas supply. The cell was rinsed and filled with buffer. With thestirrer on, pressure was applied to run more than two volumes of HCFbuffer through the membrane. From this point on, the membrane wasmaintained in a wet state.

After rinsing of the stirred cell chamber, the residual buffer wasdiscarded and the cell was filled with IgG solution. The stir plate wasthen started and the pressure applied. The antibody solution wasconcentrated to approximately one half (½) the original volume, thendiafiltered using HCF buffer (5× retentate volume). The process wasrepeated 3-4 times until the diafiltration was completed and checked tomake sure that the pH and conductivity of filtrate was identical to theHCF buffer.

Post-concentration, Polysobate-80 was added so that the finalconcentration of Polysorbate was 0.1%. The IgG was then filtered througha 0.22-μm filter, placed in clear glass vials, and stored at 2-8° C.until analytical testing was performed.

Each sample was visually inspected against a dark background under lightfor any particulates and precipitates. IgG protein concentration wasmeasured by UV (OD₂₈₀) absorbance after serial dilutions. SDS-PAGE wasperformed using pre-cast 4-20% gradient gels. Ten μL of ˜1 mg/mL samplewas heated at 95° C. for 3 minutes in the presence (reducing gel) orabsence (non-reducing gel) of a 3% 2-mercaptoethanol solution. Gels werestained with 0.1% Coomassie Blue. Isoelectric Focusing (IEF) wasperformed by standard techniques, using pH 6-10.5 gradient gels. Sampleswere diluted to 2 mg/mL and applied at 5 μL each along with pI markersand reference standard. Gels were stained with Coomassie Blue andscanned for quantification of pI range.

Size Exclusion HPLC (SE-HPLC) was carried out using a BECKMAN® HPLCsystem (Model 116), with a BIO-SIL® SEC 250 column. The sample wasdiluted to about 1 mg/mL and 60 μL was injected. The elution buffer wascomposed of 0.05 M NaH₂PO₄, 0.05 M Na₂HPO₄ and 1 mM EDTA, pH 6.8. Theelution was monitored by UV absorbance at 280 nm.

All analytical results are summarized in Table 17. The SDS-PAGE gel, IEFgel, and SE-HPLC chromatograms are not shown. Ultrafiltrationconcentration of the IgG in HCF buffer from 101 mg/mL to 213 mg/mL didnot result in any detectable changes in the purified IgG.

TABLE 17 Analytical Results Antibody hLL1 hLL2 hA20 hL243 Concentration213 mg/mL 109 mg/mL 102 mg/mL 101 mg/mL SE-HPLC 98.3% 98.5 % 98.9% 99.3%(Area Percent) (0 month) (0 Month) (0 Month) (0 Month) 97.5% 97.3% 98.5%98.8% (4 month) (12 Month) (12 Month) (12 Month) Visual Clear ClearClear Clear inspection yellowish yellowish yellowish slight milk colorcolor color color SDS-Page gel Reducing and Non-Reducing SDS-PAGE gelsfor all samples of concentrated MAb showed a band pattern similar toreference standard IEF gel IEF gel patterns for all samples ofconcentrated MAb showed a band pattern similar to reference standard

This study demonstrated that in the HCF buffer, IgG could beconcentrated by ultrafiltration up to 213 mg/mL without any visibleaggregation or precipitation. Other quality aspects of the antibody suchas molecular integrity, charge variation and solution pH were alsomaintained.

Example 11 High-Protein Concentration Antibody Formulations forSubcutaneous or Intramuscular Injection

Alternative high concentration formulations for subcutaneous orintramuscular administration may comprise amino acids, such as arginineor glutamine. A comparison of the maximal protein concentrationachievable without precipitation was determined for epratuzumab(humanized anti-CD22), using three different formulations comprising thesugar mannitol and/or the amino acids arginine and glutamic acid (Table18).

Epratuzumab was applied to a 40 mL MABSELECT® (Protein A) affinitychromatography column, which was washed with phosphate-buffered salineand then diH₂O, to remove polysorbate-80 from the original bulkmaterial. The antibody was eluted with 80 mL of 0.05 M sodium citrate,pH 3.5. The eluate was neutralized by the addition of 132 mL of 0.1 MNaH₂PO₄ and formulated into CPREM buffer by the addition of 60 mL of a 1M L-arginine monohydrochloride/1 M L-glutamic acid (monosodium salt)solution and 39.6 mL of 1 M mannitol, adjusted to pH 5.3 with HCl anddiluted to 600 mL with deionized H₂O. The final CPREM formulationcontained 66 mM mannitol, 100 mM arginine, 100 mM glutamic acid, 144 mMNa, 100 mM Cl, 7.3 mM citrate, 22 mM phosphate, pH 5.3. A proteinconcentration of 2.56 mg/mL was measured by UV spectrophotometry at 280nM (OD₂₈₀).

The 600 mL solution was concentrated 120-fold using a stir-cellconcentrator with a 50 kDa MWCO membrane. A protein concentration of 238mg/mL in the 120× concentrate was measured by OD₂₈₀. There was noevident precipitation by visual inspection and an SE-HPLC trace, whichwas indistinguishable from that of the pre-concentration material,showed no evidence of aggregation (data not shown). The 120-foldconcentrate was separated into three aliquots.

An aliquot (0.5 mL) of the 120× concentrate (238 mg/mL) was maintainedin the CPREM formulation and further concentrated to 170× (0.35 mL) andmeasured by OD₂₈₀ at a protein concentration of 298 mg/mL withoutevident precipitation. SE-HPLC analysis resolved an identical trace tothe pre-concentration material with no aggregation (data not shown).Further concentration of the 30% protein solution was not attempted dueto high viscosity and limiting volumes.

A second aliquot was diafiltered into CPRE buffer (100 mM arginine, 100mM glutamic acid, 144 mM Na, 100 mM Cl, 7.3 mM citrate, 22 mM phosphate,pH 5.3.), which is CPREM buffer without mannitol. The CPRE proteinsolution was concentrated until a precipitate was evident. At thispoint, concentration was terminated and the solution was filtered. Theprotein concentration in the filtered concentrate was measured at 99mg/mL by OD₂₈₀.

The third aliquot was diafiltered into CPM buffer (66 mM mannitol, 144mM Na, 100 mM Cl, 7.3 mM citrate, 22 mM phosphate, pH 5.3.), which isCPREM without arginine and glutamic acid. The CPM protein solution wasconcentrated until a precipitate was evident. At this point,concentration was terminated and the solution was filtered. The proteinconcentration in the filtered concentrate was measured at 137 mg/mL byOD₂₈₀.

These results suggest that addition of arginine and glutamic acid to theHCF buffer increased the maximum concentration of antibody that could bemaintained without precipitation, up to at least 300 mg/ml. Further,since maximum concentration of the hLL1 antibody that could be obtainedin HCF buffer was no higher than observed with the other testedantibodies, and substantially lower than observed with the hLL1 antibodyin HCF buffer, it is expected that comparable increases in stableantibody concentration without precipitation may be obtained for otherhighly concentrated antibodies.

TABLE 18 High-concentration epratuzumab formulations Glutamic ArginineAcid Mannitol C_(max) Formulation (mM) (mM) (mM) (mg/L) CPREM 100 100 66298^(‡) CPRE 100 100 0  99* CPM 0 0 66 137* Each formulation contained144 mM Na, 100 mM Cl, 7.3 mM citrate, 22 mM PO₄, pH 5.3 C_(max), maximalachievable concentration at the point of protein precipitation^(‡) orlimiting viscosity*

Example 12 Subcutaneous Injection of Low-Dose Veltuzumab inNon-Hodgkin's Lymphoma (NHL)

Veltuzumab was prepared for subcutaneous administration as describedabove. Seventeen patients with previously untreated or relapsed NHLreceived 4 doses of 80, 160 or 320 mg veltuzumab injected s.c. every twoweeks (Negrea et al., 2011, Haematologica 96:567-573). Responses wereassessed by CT scans, with other evaluations including adverse event,B-cell blood levels, serum veltuzumab levels and human anti-veltuzumab(HAHA) titers.

Only occasional, mild to moderate transient injection reactions wereseen with the s.c. injection and no other safety issues were observed.The s.c. veltuzumab exhibited a slow release pattern over several days,with mean maximum serum concentrations of 19, 25 and 64 μg/mL at dosagesof 80, 160 or 320 mg per injection. Transient B-cell depletion wasobserved at all dosage levels of veltuzumab. The objective response rate(partial responses plus complete responses plus complete responsesunconfirmed) was 47% (8/17) with a complete response/complete responseunconfirmed rate of 24% (4/17). Four of the eight objective responsescontinued for 60 weeks or more. Objective responses were observed at alldose levels of s.c. veltuzumab. All serum samples evaluated for humananti-veltuzumab antibody (HAHA) were negative.

It was concluded that subcutaneous injections of low-dose veltuzumab areconvenient, well-tolerated and capable of achieving sustained serumlevels, B-cell depletion and durable objective responses in indolentnon-Hodgkin's lymphoma.

What is claimed is:
 1. A method of treating hematologic cancercomprising administering a dosage of anti-HLA-DR antibody orantigen-binding fragment thereof to a human patient with a hematologiccancer by parenteral injection.
 2. The method of claim 1, wherein theadministration is by subcutaneous injection.
 3. The method of claim 1,wherein administration by subcutaneous injection does not induceinfusion-related toxicity.
 4. The method of claim 2, wherein the patienthas failed at least one prior therapy for the hematologic cancer.
 5. Themethod of claim 4, wherein the patient has failed therapy with ananti-CD20 antibody, prior to administration of the anti-HLA-DR antibody.6. The method of claim 5, wherein the patient has failed therapy withrituximab, prior to administration of the anti-HLA-DR antibody.
 7. Themethod of claim 4, wherein the patient who has failed at least one priortherapy responds to the subcutaneous anti-HLA-DR antibody.
 8. The methodof claim 1, wherein the cancer is recurrent or relapsed NHL(non-Hodgkin's lymphoma) or CLL (chronic lymphocytic leukemia).
 9. Themethod of claim 1, wherein the dosage of anti-HLA-DR antibodyadministered to the patient is 200 mg.
 10. The method of claim 9,wherein the dosage is administered once, twice or three times a week.11. The method of claim 1, wherein the cancer is selected from the groupconsisting of DLBCL (diffuse large B-cell lymphoma), follicularlymphoma, SLL (small lymphocytic lymphoma), mantle cell lymphoma,multiple myeloma, Hodgkin's lymphoma, non-Hodgkin's lymphoma, CLL, ALL(acute lymphocytic leukemia), CML (chronic myeloid leukemia), Burkittlymphoma, hairy cell leukemia and marginal zone lymphoma.
 12. The methodof claim 1, wherein the anti-HLA-DR antibody comprises a human heavychain γ4 constant region sequence with a Ser241Pro substitution.
 13. Themethod of claim 1, wherein the anti-HLA-DR antibody is a chimeric,humanized or human antibody.
 14. The method of claim 13, wherein theanti-HLA-DR antibody comprises the heavy chain complementaritydetermining region (CDR) sequences NYGMN (SEQ ID NO: 39),WINTYTREPTYADDFKG (SEQ ID NO: 40), and DITAVVPTGFDY (SEQ ID NO: 41) andthe light chain CDR sequences RASENIYSNLA (SEQ ID NO: 42), AASNLAD (SEQID NO: 43), and QHFWTTPWA (SEQ ID NO: 44).
 15. The method of claim 14,wherein the anti-HLA-DR antibody is a humanized antibody comprisinglight chain murine L243 FR residues R37, K39, V48, F49, and G100 andheavy chain murine L243 FR residues F27, K38, K46, A68, and F91.
 16. Themethod of claim 1, wherein the anti-HLA-DR antibody binds to the sameepitope of HLA-DR as a murine antibody comprising the heavy chain CDRsequences NYGMN (SEQ ID NO: 39), WINTYTREPTYADDFKG (SEQ ID NO: 40), andDITAVVPTGFDY (SEQ ID NO: 41) and the light chain CDR sequencesRASENIYSNLA (SEQ ID NO: 42), AASNLAD (SEQ ID NO: 43), and QHFWTTPWA (SEQID NO: 44).
 17. The method of claim 1, wherein the anti-HLA-DR antibodycompetes for binding to HLA-DR with a murine antibody comprising theheavy chain CDR sequences NYGMN (SEQ ID NO: 39), WINTYTREPTYADDFKG (SEQID NO: 40), and DITAVVPTGFDY (SEQ ID NO: 41) and the light chain CDRsequences RASENIYSNLA (SEQ ID NO: 42), AASNLAD (SEQ ID NO: 43), andQHFWTTPWA (SEQ ID NO: 44).
 18. The method of claim 1, wherein theanti-HLA-DR antibody is a naked antibody.
 19. The method of claim 1,wherein the anti-HLA-DR antibody is attached to at least one therapeuticagent.
 20. The method of claim 19, wherein the therapeutic agent isselected from the group consisting of a drug, a toxin, an enzyme, aradioisotope, an immunomodulator, a cytokine, a hormone, a antibody orfragment thereof, an anti-angiogenic agent, a cytotoxic agent, apro-apoptosis agent, an oligonucleotide, an siRNA and a photodynamicagent.
 21. The method of claim 20, wherein the drug is selected from thegroup consisting of 5-fluorouracil, aplidin, azaribine, anastrozole,anthracyclines, bendamustine, bleomycin, bortezomib, bryostatin-1,busulfan, calicheamycin, camptothecin, carboplatin,10-hydroxycamptothecin, carmustine, celecoxib, chlorambucil,cisplatinum, Cox-2 inhibitors, irinotecan (CPT-11), SN-38, carboplatin,cladribine, camptothecans, cyclophosphamide, cytarabine, dacarbazine,docetaxel, dactinomycin, daunorubicin, doxorubicin,2-pyrrolinodoxorubicine (2P-DOX), cyano-morpholino doxorubicin,doxorubicin glucuronide, epirubicin glucuronide, estramustine,epipodophyllotoxin, estrogen receptor binding agents, etoposide (VP16),etoposide glucuronide, etoposide phosphate, floxuridine (FUdR),3′,5′-O-dioleoyl-FudR (FUdR-dO), fludarabine, flutamide,farnesyl-protein transferase inhibitors, gemcitabine, hydroxyurea,idarubicin, ifosfamide, L-asparaginase, lenolidamide, leucovorin,lomustine, mechlorethamine, melphalan, mercaptopurine, 6-mercaptopurine,methotrexate, mitoxantrone, mithramycin, mitomycin, mitotane, navelbine,nitrosurea, plicomycin, procarbazine, paclitaxel, pentostatin, PSI-341,raloxifene, semustine, streptozocin, tamoxifen, temazolomide,transplatinum, thalidomide, thioguanine, thiotepa, teniposide,topotecan, uracil mustard, vinorelbine, vinblastine, vincristine andvinca alkaloids.
 22. The method of claim 20, wherein the toxin isselected from the group consisting of ricin, abrin, alpha toxin,saporin, ribonuclease (RNase), ranpirnase, DNase I, Staphylococcalenterotoxin-A, pokeweed antiviral protein, gelonin, diphtheria toxin,Pseudomonas exotoxin and Pseudomonas endotoxin.
 23. The method of claim20, wherein the anti-angiogenic agent is selected from the groupconsisting of angiostatin, baculostatin, canstatin, maspin, anti-VEGFantibodies, anti-P1GF peptides and antibodies, anti-vascular growthfactor antibodies, anti-Flk-1 antibodies, anti-Flt-1 antibodies andpeptides, anti-Kras antibodies, anti-cMET antibodies, anti-MIF(macrophage migration-inhibitory factor) antibodies, laminin peptides,fibronectin peptides, plasminogen activator inhibitors, tissuemetalloproteinase inhibitors, interferons, interleukin-12, IP-10, Gro-β,thrombospondin, 2-methoxyoestradiol, proliferin-related protein,carboxiamidotriazole, CM101, Marimastat, pentosan polysulphate,angiopoietin-2, interferon-alpha, herbimycin A, PNU145156E, 16Kprolactin fragment, Linomide (roquinimex), thalidomide, pentoxifylline,genistein, TNP-470, endostatin, paclitaxel, accutin, angiostatin,cidofovir, vincristine, bleomycin, AGM-1470, platelet factor 4 andminocycline.
 24. The method of claim 20, wherein the immunomodulator isselected from the group consisting of erythropoietin, thrombopoietin,granulocyte-colony stimulating factor (G-CSF), granulocytemacrophage-colony stimulating factor (GM-CSF), interferon-α,interferon-β, interferon-γ, “S1 factor”, human growth hormone,N-methionyl human growth hormone, bovine growth hormone, parathyroidhormone, thyroxine, insulin, proinsulin, relaxin, prorelaxin, folliclestimulating hormone (FSH), thyroid stimulating hormone (TSH),luteinizing hormone (LH), hepatic growth factor, prostaglandin,fibroblast growth factor, prolactin, placental lactogen, OB protein,tumor necrosis factor-α, tumor necrosis factor-β, mullerian-inhibitingsubstance, mouse gonadotropin-associated peptide, inhibin, activin,vascular endothelial growth factor, integrin, NGF-β, platelet-growthfactor, TGF-α, TGF-β, insulin-like growth factor-I, insulin-like growthfactor-II, macrophage-CSF (M-CSF), IL-1, IL-1α, IL-2, IL-3, IL-4, IL-5,IL-6, IL-7, IL-8, IL-9, IL-10, IL-11, IL-12, IL-13, IL-14, IL-15, IL-16,IL-17, IL-18, IL-21, IL-25, LIF, kit-ligand, angiostatin,thrombospondin, endostatin, tumor necrosis factor and LT.
 25. The methodof claim 20, wherein the radionuclide is selected from the groupconsisting of ¹⁸F, ³²P, ³³P, ⁴⁵Ti, ⁴⁷Sc, ⁵²Fe, ⁵⁹Fe, ⁶²CU, ⁶⁴Cu, ⁶⁷Cu,⁶⁷Ga, ⁶⁸Ga, ⁷⁵Se, ⁷⁷As, ⁸⁶Y, ⁸⁹Sr, ⁸⁹Zr, ⁹⁰Y, ⁹⁴Tc, ^(94m)Tc, ⁹⁹Mo,^(99m)Tc, ¹⁰⁵Pd, ¹⁰⁵Rh, ¹¹¹Ag, ¹¹¹In, ¹²³I, ¹²⁴I, ¹²⁵I, ¹³¹I, ¹⁴²Pr,¹⁴³Pr, ¹⁴⁹Pm, ¹⁵³Sm, ¹⁵⁴⁻¹⁵⁸Gd, ¹⁶¹Tb, ¹⁶⁶Dy, ¹⁶⁶Ho, ¹⁶⁹Er, ¹⁷⁵Lu,¹⁷⁷Lu, ¹⁸⁶Re, ¹⁸⁸Re, ¹⁸⁹Re, ¹⁹⁴Ir, ¹⁹⁸Au ¹⁹⁹Au, ²¹¹At, ²¹¹Pb ²¹²Bi,²¹²Pb, ²¹³Bi, ²²³Ra, ²²⁷Th and ²²⁵Ac.
 26. The method of claim 1, furthercomprising administering to the patient an anti-CD20 antibody orfragment thereof, wherein administration of the anti-HLA-DR antibody andthe anti-CD20 antibody inhibits proliferation of the hematologic cancermore than either anti-HLA-DR antibody or anti-CD20 antibody alone. 27.The method of claim 18, further comprising administering at least onetherapeutic agent to the patient.
 28. A method of treating an autoimmuneor immune dysfunction disease comprising administering a dosage ofanti-HLA-DR antibody or antigen-binding fragment thereof to a humanpatient with an autoimmune disease by subcutaneous injection.
 29. Themethod of claim 28, wherein the autoimmune or immune dysfunction diseaseis selected from the group consisting of acute idiopathicthrombocytopenic purpura, chronic idiopathic thrombocytopenic purpura,dermatomyositis, Sydenham's chorea, myasthenia gravis, systemic lupuserythematosus, lupus nephritis, rheumatic fever, polyglandularsyndromes, bullous pemphigoid, diabetes mellitus, Henoch-Schonleinpurpura, post-streptococcal nephritis, erythema nodosum, Takayasu'sarteritis, Addison's disease, rheumatoid arthritis, multiple sclerosis,sarcoidosis, ulcerative colitis, erythema multiforme, IgA nephropathy,polyarteritis nodosa, ankylosing spondylitis, Goodpasture's syndrome,thromboangitis obliterans, Sjogren's syndrome, primary biliarycirrhosis, Hashimoto's thyroiditis, thyrotoxicosis, scleroderma, chronicactive hepatitis, polymyositis/dermatomyositis, polychondritis,pemphigus vulgaris, Wegener's granulomatosis, membranous nephropathy,amyotrophic lateral sclerosis, tabes dorsalis, giant cellarteritis/polymyalgia, pernicious anemia, rapidly progressiveglomerulonephritis, psoriasis, fibrosing alveolitis, GVHD(graft-versus-host disease) and organ transplant rejection.
 30. Themethod of claim 29, wherein the patient has failed at least one priortherapy for the autoimmune disease.
 31. The method of claim 30, whereinthe patient has failed therapy with an anti-CD20 antibody, prior toadministration of the anti-HLA-DR antibody.
 32. The method of claim 28,wherein the dosage of anti-HLA-DR antibody is 200 mg.
 33. The method ofclaim 32, wherein the dosage is administered once, twice or three timesa week.
 34. The method of claim 28, wherein the anti-HLA-DR antibodycomprises a human heavy chain γ4 constant region sequence with aSer241Pro substitution.
 35. The method of claim 28, wherein theanti-HLA-DR antibody is a chimeric, humanized or human antibody.
 36. Themethod of claim 35, wherein the anti-HLA-DR antibody comprises the heavychain complementarity determining region (CDR) sequences NYGMN (SEQ IDNO: 39), WINTYTREPTYADDFKG (SEQ ID NO: 40), and DITAVVPTGFDY (SEQ ID NO:41) and the light chain CDR sequences RASENIYSNLA (SEQ ID NO: 42),AASNLAD (SEQ ID NO: 43), and QHFWTTPWA (SEQ ID NO: 44).
 37. The methodof claim 36, wherein the anti-HLA-DR antibody is a humanized antibodycomprising light chain murine L243 FR residues R37, K39, V48, F49, andG100 and heavy chain murine L243 FR residues F27, K38, K46, A68, andF91.
 38. The method of claim 28, wherein the anti-HLA-DR antibody bindsto the same epitope of HLA-DR as a murine antibody comprising the heavychain CDR sequences NYGMN (SEQ ID NO: 39), WINTYTREPTYADDFKG (SEQ ID NO:40), and DITAVVPTGFDY (SEQ ID NO: 41) and the light chain CDR sequencesRASENIYSNLA (SEQ ID NO: 42), AASNLAD (SEQ ID NO: 43), and QHFWTTPWA (SEQID NO: 44).
 39. The method of claim 28, wherein the anti-HLA-DR antibodycompetes for binding to HLA-DR with a murine antibody comprising theheavy chain CDR sequences NYGMN (SEQ ID NO: 39), WINTYTREPTYADDFKG (SEQID NO: 40), and DITAVVPTGFDY (SEQ ID NO: 41) and the light chain CDRsequences RASENIYSNLA (SEQ ID NO: 42), AASNLAD (SEQ ID NO: 43), andQHFWTTPWA (SEQ ID NO: 44).
 40. The method of claim 28, wherein theanti-HLA-DR antibody is a naked antibody.
 41. The method of claim 28,wherein the anti-HLA-DR antibody is attached to at least one therapeuticagent selected from the group consisting of a drug, an enzyme, animmunomodulator, a cytokine, a hormone, an antibody or fragment thereof,an oligonucleotide, an siRNA and a photodynamic agent.